1
|
Brand A, Hornig C, Crayen C, Hamann A, Martineck S, Leistner DM, Dreger H, Sündermann S, Unbehaun A, Sherif M, Haghikia A, Bischoff S, Lueg J, Kühnle Y, Paul O, Squier S, Stangl K, Falk V, Landmesser U, Stangl V. Medical graphics to improve patient understanding and anxiety in elderly and cognitively impaired patients scheduled for transcatheter aortic valve implantation (TAVI). Clin Res Cardiol 2023:10.1007/s00392-023-02352-8. [PMID: 38117299 DOI: 10.1007/s00392-023-02352-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 11/29/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Anxiety and limited patient comprehension may pose significant barriers when informing elderly patients about complex procedures such as transcatheter aortic valve implantation (TAVI). OBJECTIVES We aimed to evaluate the utility of medical graphics to improve the patient informed consent (IC) before TAVI. METHODS In this prospective, randomized dual center study, 301 patients were assigned to a patient brochure containing medical graphics (Comic group, n = 153) or sham information (Control group, n = 148) on top of usual IC. Primary outcomes were patient understanding of central IC-related aspects and periprocedural anxiety assessed by the validated Spielberger State Trait Anxiety Inventory (STAI), both analyzed by cognitive status according to the Montreal Cognitive Assessment (MoCA). RESULTS Patient understanding was significantly higher in the Comic group [mean number of correct answers 12.8 (SD 1.2) vs. 11.3 (1.8); mean difference 1.5 (95% CI 1.2-1.8); p < 0.001]. This effect was more pronounced in the presence of cognitive dysfunction (MoCA < 26) [12.6 (1.2) in the Comic vs. 10.9 (1.6) in the Control group; mean difference 1.8 (1.4-2.2), p < 0.001]. Mean STAI score declined by 5.7 (95% CI 5.1-6.3; p < 0.001) in the Comic and 0.8 points (0.2-1.4; p = 0.015) in the Control group. Finally, mean STAI score decreased in the Comic group by 4.7 (3.8-5.6) in cognitively impaired patients and by 6.6 (95% CI 5.8 to 7.5) in patients with normal cognitive function (p < 0.001 each). CONCLUSIONS Our results prove beneficial effects for using medical graphics to inform elderly patients about TAVI by improving patient understanding and reducing periprocedural anxiety (DRKS00021661; 23/Oct/2020). Medical graphics entailed significant beneficial effects on the primary endpoints, patient understanding and periprocedural anxiety, compared to the usual patient informed consent (IC) procedure. Patient understanding of IC-related aspects was significantly higher in the Comic group, with a more pronounced benefit in patients with cognitive impairment (p for IC method and cognitive status < 0.001, respectively; p for IC method x MoCA category interaction = 0.017). There further was a significant decline of periprocedural anxiety in patients with and without cognitive impairment (p for IC method x measuring time point < 0.001; p for IC method x MoCA category x measuring time point interaction = 0.018).
Collapse
Affiliation(s)
- A Brand
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Charité Mitte, Berlin, Germany.
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Benjamin Franklin, Berlin, Germany.
- DZHK (German Centre for Cardiovascular Research), partner Site Berlin, Berlin, Germany.
| | - C Hornig
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Charité Mitte, Berlin, Germany
| | - C Crayen
- Department of Education and Psychology, Freie Universität Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany
| | - A Hamann
- Mintwissen-Science Communication Agency and Publishing House, Paulusstr. 11, 40237, Düsseldorf, Germany
| | | | - D M Leistner
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Benjamin Franklin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner Site Berlin, Berlin, Germany
- Department of Cardiology, Angiology and Intensive Care Medicine, Goethe University Hospital, Universitäres Herz- und Gefässzentrum Frankfurt, Frankfurt am Main, 60590, Frankfurt, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Rhein-Main, Munich, Germany
| | - H Dreger
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Charité Mitte, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner Site Berlin, Berlin, Germany
| | - S Sündermann
- DZHK (German Centre for Cardiovascular Research), partner Site Berlin, Berlin, Germany
- Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité, Berlin, Germany
| | - A Unbehaun
- Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité, Berlin, Germany
| | - M Sherif
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Virchow Klinikum, Berlin, Germany
| | - A Haghikia
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Benjamin Franklin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner Site Berlin, Berlin, Germany
| | - S Bischoff
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Charité Mitte, Berlin, Germany
| | - J Lueg
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Charité Mitte, Berlin, Germany
| | - Y Kühnle
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Virchow Klinikum, Berlin, Germany
| | - O Paul
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Virchow Klinikum, Berlin, Germany
| | - S Squier
- Brill Professor Emeritus of English and Women's, Gender and Sexuality Studies, The Pennsylvania State University, University Park, PA, 16802, USA
| | - K Stangl
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Charité Mitte, Berlin, Germany
| | - V Falk
- DZHK (German Centre for Cardiovascular Research), partner Site Berlin, Berlin, Germany
- Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité, Berlin, Germany
| | - U Landmesser
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Benjamin Franklin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner Site Berlin, Berlin, Germany
| | - V Stangl
- Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité, Campus Charité Mitte, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner Site Berlin, Berlin, Germany
| |
Collapse
|
2
|
Ranaivo H, Zhang Z, Alligier M, Lambert-Porcheron S, Feugier-Favier N, Cuerq C, Machon C, Neyrinck A, Seethaler B, Rodriguez J, Muccioli G, Maquet V, Laville M, Bischoff S, Walter J, Delzenne N, Nazare JA. Impact de la supplémentation en chitine-glucane chez le sujet à risque cardiométabolique : focus sur le métabolisme postprandial et le microbiote intestinal. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
3
|
Hoyer K, Hablesreiter R, Inoue Y, Yoshida K, Briest F, Christen F, Kakiuchi N, Yoshizato T, Shiozawa Y, Shiraishi Y, Striefler JK, Bischoff S, Lohneis P, Putter H, Blau O, Keilholz U, Bullinger L, Pelzer U, Hummel M, Riess H, Ogawa S, Sinn M, Damm F. A genetically defined signature of responsiveness to erlotinib in early-stage pancreatic cancer patients: Results from the CONKO-005 trial. EBioMedicine 2021; 66:103327. [PMID: 33862582 PMCID: PMC8054140 DOI: 10.1016/j.ebiom.2021.103327] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/16/2021] [Accepted: 03/19/2021] [Indexed: 12/18/2022] Open
Abstract
Background high recurrence rates of up to 75% within 2 years in pancreatic ductal adenocarcinoma (PDAC) patients resected for cure indicate a high medical need for clinical prediction tools and patient specific treatment approaches. Addition of the EGFR inhibitor erlotinib to adjuvant chemotherapy failed to improve outcome but its efficacy in some patients warrants predictors of responsiveness. Patients and Methods we analysed tumour samples from 293 R0-resected patients from the randomized, multicentre phase III CONKO-005 trial (gemcitabine ± erlotinib) with targeted sequencing, copy number, and RNA expression analyses. Findings a total of 1086 mutations and 4157 copy-number aberrations (CNAs) with a mean of 17.9 /tumour were identified. Main pathways affected by genetic aberrations were the MAPK-pathway (99%), cell cycle control (92%), TGFβ signalling (77%), chromatin remodelling (71%), and the PI3K/AKT pathway (65%). Based on genetic signatures extracted with non-negative matrix factorization we could define five patient clusters, which differed in mutation patterns, gene expression profiles, and survival. In multivariable Cox regression analysis, SMAD4 aberrations were identified as a negative prognostic marker in the gemcitabine arm, an effect that was counteracted when treated with erlotinib (DFS: HR=1.59, p = 0.016, and OS: HR = 1.67, p = 0.014). Integration of differential gene expression analysis established SMAD4 alterations with low MAPK9 expression (n = 91) as a predictive biomarker for longer DFS (HR=0.49; test for interaction, p = 0.02) and OS (HR = 0.32; test for interaction, p = 0.001). Interpretation this study identified five biologically distinct patient clusters with different actionable lesions and unravelled a previously unappreciated association of SMAD4 alteration status with erlotinib effectiveness. Confirmatory studies and mechanistic experiments are warranted to challenge the hypothesis that SMAD4 status might guide addition of erlotinib treatment in early-stage PDAC patients.
Collapse
Affiliation(s)
- K Hoyer
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - R Hablesreiter
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Inoue
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - K Yoshida
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - F Briest
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - F Christen
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - N Kakiuchi
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Yoshizato
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Shiozawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Shiraishi
- Laboratory of DNA information Analysis, Human Genome Centre, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - J K Striefler
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - S Bischoff
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - P Lohneis
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Pathology, Berlin, Germany; Institute of Pathology, University of Cologne, Cologne, Germany
| | - H Putter
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - O Blau
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - U Keilholz
- Charité Comprehensive Cancer Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - L Bullinger
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - U Pelzer
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - M Hummel
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Pathology, Berlin, Germany
| | - H Riess
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - S Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Institute for the Advanced Study of Human Biology (WPI-ASHBi), Kyoto University, Kyoto, Japan; Department of Medicine, Centre for Haematology and Regenerative Medicine, Karolinska Institute, Stockholm, Sweden
| | - M Sinn
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany; Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F Damm
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany; German Cancer Consortium (DKTK), partner site Berlin, Berlin, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany.
| |
Collapse
|
4
|
Sinn M, Pollich C, Riess H, Bischoff S, Habbel P, Scholz C, Spaeth-Schwalbe E, de Wit M, Jühling A, Wolter E, Wislocka L, Klamroth R. PO-37 How are patients with active cancer and venous thromboembolism (VTE) treated in Germany? Answers from GECAT (German Evaluation of Cancer Associated Thrombosis). Thromb Res 2021. [DOI: 10.1016/s0049-3848(21)00210-3] [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]
|
5
|
Leitzke M, Schimpf S, Altrock M, Schönknecht P, Bischoff S, Schubert H, Hoyer D, Bauer R, Olbrich S. Afferent vagal stimulation via gastric electrical stimulation alters sympathetic-vagal balance in domestic pigs - a pilot trial. J BIOL REG HOMEOS AG 2021; 35:11-24. [PMID: 33474908 DOI: 10.23812/20-527-a] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The disturbance of the sympathetic-vagal balance with increasing sympathetic activity and consecutive increase in cytokine release is a major threat in numerous hyperinflammatory syndromes. Therapeutic interventions that modulate the activity in the sympathetic-vagal system are suggested as an effective treatment in these incidences. The purpose of this pilot study was to investigate the effect of electrical stimulation of the gastric wall on sympathetic-vagal balance. German domestic pigs (n=5) were prepared with a modified gastric tube (mGT) for repetitive gastric electrical stimulation (GES). Electrocardiogram was recorded continuously and heart rate variability (HRV) as measure of sympathetic-vagal activity was calculated for three-minute epochs at baseline condition before GES and during GES condition. In comparison to baseline, activity of the autonomic nervous system (ANS) shifted significantly toward increased dominance of vagal activity during GES with a decrease of normalized low frequency (nLF from 58.00 to 25.52) as marker of sympathetic dominance and parallel increase of normalized high frequency (nHF from 41.48 to 74.16) as marker of vagal dominance. During GES, compared to baseline, no difference in heart rate was found. These results indicate that electrical stimulation of the gastric wall may result in shifting the sympathetic-vagal balance toward a parasympathetic predominance.
Collapse
Affiliation(s)
- M Leitzke
- Helios Clinics, Department of Anaesthesiology, Leisnig, Germany
| | - S Schimpf
- Dräger Medical GmbH, Lübeck, Germany
| | - M Altrock
- MTU Reman Technologies GmbH, Magdeburg, Germany
| | - P Schönknecht
- Leipzig University, Medical faculty, Saxon hospital, Arnsdorf, Germany
| | - S Bischoff
- University of Jena, Institute for animal testing, experimentation and animal welfare, Jena, Germany
| | - H Schubert
- University of Jena, Institute for animal testing, experimentation and animal welfare, Jena, Germany
| | - D Hoyer
- University of Jena, Hans Berger Department of Neurology, Jena, Germany
| | - R Bauer
- University of Jena, Institute for molecular cell biology, Jena, Germany
| | - S Olbrich
- University of Zurich, Department of Psychiatry, Zürich, Switzerland
| |
Collapse
|
6
|
Steiner UC, Bischoff S, Valaperti A, Ikenberg K, Starzyk J, Bucher S, Bachmann LM, Soyka MB. Endotypes of chronic rhinosinusitis with nasal polyps with and without NSAID â€" intolerance. Rhinology 2021; 58:544-549. [PMID: 32692786 DOI: 10.4193/rhin19.423] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2-dominated inflammatory disease of the upper air- ways. A subgroup of patients with CRSwNP suffer from intolerance to nonsteroidal anti-inflammatory drugs (NSAID) and develop NSAID-exacerbated respiratory disease (NERD). The aim of the study was to compare the cytokine based inflammatory endotype of nasal secretions of CRSwNP patients with and without NSAID intolerance. METHODS Nasal secretions were collected from twenty-six patients suffering from CRSwNP, thirteen with NERD and thirteen without NSAID intolerance. As control, nasal secretions were collected from fifteen healthy donors. Tryptase and ten human cyto- kines were analyzed: interleukin (IL)-4, IL-5, IL-6, IL-8, IL-12p70, IL-13, IL-17A, IL-23, IFN-g, and TNF-a by a cytokine multiple array on a Luminex 200 platform. RESULTS Grade of polyposis and frequency of polyp surgery was more severe in NERD- compared to non-NERD patients. IL-6 and IL-5 in CRSwNP was significantly increased compared to healthy participants. IL-5 and IL-13 were significantly increased in subjects suffering from NERD compared to CRSwNP patients without NERD. CONCLUSION We identified IL-13 as a possible specific biomarker in nasal secretions of patients with NERD, which allows us to differentiate between CRSwNP with vs. without NERD. The characterization of inflammatory endotypes in CRSwNP enables the introduction of the best available therapy in the context of precision medicine.
Collapse
Affiliation(s)
- U C Steiner
- Department of Immunology, University Hospital Zurich, Zurich, Switzerland
| | - S Bischoff
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital and University of Zurich, Zurich, Switzerland
| | - A Valaperti
- Department of Immunology, University Hospital Zurich, Zurich, Switzerland
| | - K Ikenberg
- Department of Pathology and Molecular Pathology, University Hospital and University of Zurich, Zurich, Switzerland
| | - J Starzyk
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital and University of Zurich, Zurich, Switzerland
| | - S Bucher
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital and University of Zurich, Zurich, Switzerland
| | - L M Bachmann
- Medignition - Healthcare Innovations, Zurich, Switzerland
| | - M B Soyka
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital and University of Zurich, Zurich,Switzerland
| |
Collapse
|
7
|
Bischoff S, Poletti SC, Kunz S, Kiessling SY, Hinder D, Dreher A, Akdis CA, Soyka MB. Trigeminal endonasal perception - an outcome predictor for septoplasty. Rhinology 2021; 58:437-443. [PMID: 32500869 DOI: 10.4193/rhin19.292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND No adequate test exists to predict outcome after septoplasty. Despite adequate surgery, patients still might experience nasal breathing impairment. The aim of this study was to determine if pre-operative trigeminal sensitivity can predict satisfaction after septoplasty. METHODS Single centre prospective cohort study in tertiary referral centre with follow-up time of 6 weeks postoperatively. Patients scheduled for septoplasty or septorhinoplasty with turbinoplasty were consecutively selected the day before surgery. Standard preoperative examinations (acoustic rhinometry and Sniffin’ Sticks 12 test), the evaluation of nasal obstruction on a visual analogue scale (VAS) and the trigeminal lateralisation task were performed before and 6 weeks after surgery. Biopsies were taken during surgery and TRPV1 mRNA expression was measured by PCR. RESULTS Thirty patients were included with a median age of 29 years and equal gender distribution. Trigeminal perception and sensation of nasal obstruction showed a significant correlation: preoperative lateralisation test scores, representing endonasal trigeminal sensitivity, correlated significantly with the mean VAS change scores, which demonstrate subjective improvement. A lateralisation test score of 31.5 and more had a sensitivity of 88% to predict an improvement of more than 3 VAS points. Additionally, high TRPV1 mRNA expression was linked with good postoperative VAS scores. CONCLUSION The preoperative evaluation of the trigeminal sensitivity could improve patients’ selection for septoplasty with a higher rate of satisfaction. Endonasal trigeminal sensitivity is directly linked with subjective outcome. Therefore, patients with low trigeminal sensitivity should undergo septoplasty only after thorough counselling.
Collapse
Affiliation(s)
- S Bischoff
- Department of Otorhinolaryngology Head and Neck Surgery, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - S C Poletti
- Department of Otorhinolaryngology Head and Neck Surgery, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universitat Dresden, Dresden, Germany; Department of Otorhinolaryngology-Head and Neck Surgery, University of Tubingen, Tubingen, Germany
| | - S Kunz
- Department of Otorhinolaryngology Head and Neck Surgery, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - S-Y Kiessling
- Department of Otorhinolaryngology Head and Neck Surgery, Kantonsspital St.Gallen, St.Gallen, Switzerland
| | - D Hinder
- Department of Otorhinolaryngology Head and Neck Surgery, Luzerner Kantonsspital, Luzern, Switzerland
| | - A Dreher
- Swiss Institute of Asthma and Allergy Research (SIAF), University of Zurich, Davos Switzerland
| | - C A Akdis
- Swiss Institute of Asthma and Allergy Research (SIAF), University of Zurich, Davos Switzerland
| | - M B Soyka
- Department of Otorhinolaryngology Head and Neck Surgery, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
8
|
Maenz S, Brinkmann O, Hasenbein I, Braun C, Kunisch E, Horbert V, Gunnella F, Sachse A, Bischoff S, Schubert H, Jandt KD, Bossert J, Driesch D, Kinne RW, Bungartz M. The old sheep: a convenient and suitable model for senile osteopenia. J Bone Miner Metab 2020; 38:620-630. [PMID: 32296985 DOI: 10.1007/s00774-020-01098-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 03/08/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Existing osteoporosis models in sheep exhibit some disadvantages, e.g., challenging surgical procedures, serious ethical concerns, failure of reliable induction of substantial bone loss, or lack of comparability to the human condition. This study aimed to compare bone morphological and mechanical properties of old and young sheep, and to evaluate the suitability of the old sheep as a model for senile osteopenia. MATERIALS AND METHODS The lumbar vertebral body L3 of female merino sheep with two age ranges, i.e., old animals (6-10 years; n = 41) and young animals (2-4 years; n = 40), was analyzed concerning its morphological and mechanical properties by bone densitometry, quantitative histomorphometry, and biomechanical testing of the corticalis and/or central spongious region. RESULTS In comparison with young sheep, old animals showed only marginally diminished bone mineral density of the vertebral bodies, but significantly decreased structural (bone volume, - 15.1%; ventral cortical thickness, - 11.8%; lateral cortical thickness, - 12.2%) and bone formation parameters (osteoid volume, osteoid surface, osteoid thickness, osteoblast surface, all - 100.0%), as well as significantly increased bone erosion (eroded surface, osteoclast surface). This resulted in numerically decreased biomechanical properties (compressive strength; - 6.4%). CONCLUSION Old sheep may represent a suitable model of senile osteopenia with markedly diminished bone structure and formation, and substantially augmented bone erosion. The underlying physiological aging concept reduces challenging surgical procedures and ethical concerns and, due to complex alteration of different facets of bone turnover, may be well representative of the human condition.
Collapse
Affiliation(s)
- Stefan Maenz
- Chair of Materials Science, Otto Schott Institute of Materials Research, Friedrich-Schiller-University Jena, Jena, Germany
| | - Olaf Brinkmann
- Chair of Orthopedics, Department of Orthopedics, Jena University Hospital, Waldkliniken Eisenberg GmbH, Eisenberg, Germany
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkliniken Eisenberg GmbH, Klosterlausnitzer Str. 81, 07607, Eisenberg, Germany
| | - Ines Hasenbein
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkliniken Eisenberg GmbH, Klosterlausnitzer Str. 81, 07607, Eisenberg, Germany
| | - Christina Braun
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkliniken Eisenberg GmbH, Klosterlausnitzer Str. 81, 07607, Eisenberg, Germany
| | - Elke Kunisch
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkliniken Eisenberg GmbH, Klosterlausnitzer Str. 81, 07607, Eisenberg, Germany
| | - Victoria Horbert
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkliniken Eisenberg GmbH, Klosterlausnitzer Str. 81, 07607, Eisenberg, Germany
| | - Francesca Gunnella
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkliniken Eisenberg GmbH, Klosterlausnitzer Str. 81, 07607, Eisenberg, Germany
| | - André Sachse
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkliniken Eisenberg GmbH, Klosterlausnitzer Str. 81, 07607, Eisenberg, Germany
| | - Sabine Bischoff
- Institute of Laboratory Animal Sciences and Welfare, Jena University Hospital, Jena, Germany
| | - Harald Schubert
- Institute of Laboratory Animal Sciences and Welfare, Jena University Hospital, Jena, Germany
| | - Klaus D Jandt
- Chair of Materials Science, Otto Schott Institute of Materials Research, Friedrich-Schiller-University Jena, Jena, Germany
| | - Jörg Bossert
- Chair of Materials Science, Otto Schott Institute of Materials Research, Friedrich-Schiller-University Jena, Jena, Germany
| | | | - Raimund W Kinne
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkliniken Eisenberg GmbH, Klosterlausnitzer Str. 81, 07607, Eisenberg, Germany.
| | - Matthias Bungartz
- Chair of Orthopedics, Department of Orthopedics, Jena University Hospital, Waldkliniken Eisenberg GmbH, Eisenberg, Germany
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkliniken Eisenberg GmbH, Klosterlausnitzer Str. 81, 07607, Eisenberg, Germany
| |
Collapse
|
9
|
Abstract
BACKGROUND Several studies have demonstrated a significant benefit of neuromuscular facial training in the rehabilitation of patients with facial palsy. However, printed instructions for home training are often not of optimum quality and associated with low adherence to therapy. Professional guidance, e.g., by occupational therapists, is regarded as being of high quality, but is associated with a high cost burden, particularly in chronic forms of disease. OBJECTIVE The idea to develop a smartphone app for facial training arose from the above-described situation. The aim was to provide structured exercises for the mimic muscles in the sense of neuromuscular training with visual feedback via the front camera of the device. MATERIALS AND METHODS A native app architecture in iOS was chosen to implement the graphical and content-related concept. In the Apple Xcode (Apple, Cupertino, CA, US) development environment, the app's code was written in the Swift programming language (Apple) and the graphical user interface was created. RESULTS An app prototype was implemented that provides step-by-step instructions on selected mimic exercises via animated smileys. The duration and speed of the exercise can be varied within a limited range. In the development environment, the correct functionality of both physical and virtual devices was successfully tested. CONCLUSION App-based facial training offers attractive opportunities to motivate patients for improved adherence to treatment, which could hypothetically lead to a better outcome. Evaluation of this question is planned in a clinical trial after completion of the development.
Collapse
Affiliation(s)
- J Taeger
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany.
| | - S Bischoff
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany
| | - R Hagen
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany
| | - K Rak
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany
| |
Collapse
|
10
|
Taeger J, Bischoff S, Hagen R, Rak K. [Development of a smartphone app for neuromuscular facial training. German Version]. HNO 2020; 68:726-733. [PMID: 32495061 DOI: 10.1007/s00106-020-00879-0] [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] [Indexed: 10/24/2022]
Abstract
BACKGROUND Several studies have demonstrated a significant benefit of neuromuscular facial training in the rehabilitation of patients with facial palsy. However, printed instructions for home training are often not of optimum quality and associated with low adherence to therapy. Professional guidance, e.g., by occupational therapists, is regarded as being of high quality, but is associated with a high cost burden, particularly in chronic forms of disease. OBJECTIVE The idea to develop a smartphone app for facial training arose from the above-described situation. The aim was to provide structured exercises for the mimic muscles in the sense of neuromuscular training with visual feedback via the front camera of the device. MATERIALS AND METHODS A native app architecture in iOS was chosen to implement the graphical and content-related concept. In the Apple Xcode (Apple, Cupertino, California, US) development environment, the app's code was written in the Swift programming language (Apple) and the graphical user interface was created. RESULTS An app prototype was implemented that provides step-by-step instructions on selected mimic exercises via animated smileys. The duration and speed of the exercise can be varied within a limited range. In the development environment, the correct functionality of both physical and virtual devices was successfully tested. CONCLUSION App-based facial training offers attractive opportunities to motivate patients for improved adherence to treatment, which could hypothetically lead to a better outcome. Evaluation of this question is planned in a clinical trial after completion of the development.
Collapse
Affiliation(s)
- J Taeger
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland.
| | - S Bischoff
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - R Hagen
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - K Rak
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| |
Collapse
|
11
|
Weinrebe W, Schiefer Y, Weckmüller K, Schulz RJ, Rupp S, Bischoff S, Karaman M, Goetz S, Heppner HJ, Polidori MC. Does the identification of seniors at risk (ISAR) score effectively select geriatric patients on emergency admission? Aging Clin Exp Res 2019; 31:1839-1842. [PMID: 30623316 DOI: 10.1007/s40520-018-1105-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 12/14/2018] [Indexed: 01/01/2023]
Abstract
The number of older patients admitted to emergency departments (ED) increases continuously. The Identification of Seniors at Risk (ISAR) score is currently recommended to screen patients in German ED, but its appropriateness is being criticized. ISAR scores and clinical characteristics from 98 emergency admissions (EA), 80 from acute geriatrics (AG) and 89 from a geriatric rehabilitation (GR) unit were compared retrospectively. No significant differences were found between groups, being the ISAR score positive in 87.7% of EA, 94.9% of AG and 94.4% of GR cases. None of positively identified geriatric patients in the EA was transferred to the geriatric ward of competence. EA patients showed significantly higher number of functional impairments (p = 0.001) and higher BI score (p < 0.0001) compared to AG and GR groups. A higher ISAR score threshold and additional functional information might be needed to better select patients in need of prompt treatment by a geriatric team.
Collapse
Affiliation(s)
- W Weinrebe
- Department of Geriatrics, Hospital Meyriez and Tafers, HFR, University Fribourg, Fribourg, Switzerland.
| | - Y Schiefer
- Ageing Clinical Research, Department of Internal Medicine II, University Hospital Cologne, Cologne, North Rhine Westphalia, Germany
| | - K Weckmüller
- Clinic for Orthopedics and Trauma Surgery, Coblenz, Rhineland-Palatibate, Germany
| | - R J Schulz
- Department of Geriatrics, St. Marien Hospital, Cologne, North Rhine Westphalia, Germany
| | - S Rupp
- Department of Geriatrics/Rehabilitation, Clinic Wartenberg, Wartenberg, Bavaria, Germany
| | - S Bischoff
- Outpatient Clinic for Occupational Therapy, Bad Friedrichshall, Baden-Württemberg, Germany
| | - M Karaman
- Institute for Biostatistics, Berlin, Germany
| | - S Goetz
- Department of Geriatrics, Hospital Meyriez and Tafers, HFR, University Fribourg, Fribourg, Switzerland
| | - H J Heppner
- Department of Geriatrics, Helios Clinic Schwelm, University Witten-Herdecke, Witten, North Rhine Westphalia, Germany
| | - M C Polidori
- Ageing Clinical Research, Department of Internal Medicine II, University Hospital Cologne, Cologne, North Rhine Westphalia, Germany
| |
Collapse
|
12
|
Bischoff S, Gerth-Kahlert C, Holzmann D, Soyka MB. Longstanding diplopia after ethmoidal artery ligation for epistaxis. Eur Arch Otorhinolaryngol 2019; 277:161-167. [PMID: 31667574 DOI: 10.1007/s00405-019-05686-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 10/08/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE In the rare case of intractable, posterior, non-sphenopalatine artery epistaxis, ligation of ethmoidal arteries using an external approach like a Lynch-type incision is required. Orbital complications, especially extra-ocular motility disorders with diplopia, are known, but in the literature rarely described. Our aim was to analyse the complication type, rate, and outcome of ethmoidal artery ligation for epistaxis. MATERIALS AND METHODS Data between 2012 and 2017 of patients treated with ethmoidal artery ligation were analysed retrospectively and through a telephone interview using a non-standardized questionnaire. RESULTS Data of 18 patients (m/f = 3/15) aged 53-83 years were reviewed. Epistaxis recurred in only one patient after 1 month. Five patients (28%) suffered from diplopia shortly after surgery. Motility analysis revealed full recovery with free motility in four out of five reported cases after 4-8 months, one patient still reports intermittent mild diplopia more than 1 year postoperatively. CONCLUSION In patients with intractable, non-sphenopalatine artery epistaxis, anterior ethmoidal artery ligation was highly effective. Diplopia, however, occurred in one-third of our patient group. Information about motility restriction with longer standing diplopia are mandatory when consenting patients for ligation of ethmoidal arteries. Special care needs to be taken during dissection in the region of the trochlea and superior oblique muscle. LEVEL OF EVIDENCE Case Series, level 4.
Collapse
Affiliation(s)
- S Bischoff
- Department of Otorhinolaryngology Head and Neck Surgery, University of Zurich and University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland
| | - C Gerth-Kahlert
- Department of Ophthalmology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - D Holzmann
- Department of Otorhinolaryngology Head and Neck Surgery, University of Zurich and University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland
| | - M B Soyka
- Department of Otorhinolaryngology Head and Neck Surgery, University of Zurich and University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland.
| |
Collapse
|
13
|
Grohmann S, Menne M, Hesse D, Bischoff S, Schiffner R, Diefenbeck M, Liefeith K. Biomimetic multilayer coatings deliver gentamicin and reduce implant-related osteomyelitis in rats. ACTA ACUST UNITED AC 2019; 64:383-395. [PMID: 30173199 DOI: 10.1515/bmt-2018-0044] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 07/16/2018] [Indexed: 02/01/2023]
Abstract
Implant-related infections like periprosthetic joint infections (PJI) are still a challenging issue in orthopedic surgery. In this study, we present a prophylactic anti-infective approach based on a local delivery of the antibiotic gentamicin. The local delivery is achieved via a nanoscale polyelectrolyte multilayer (PEM) coating that leaves the bulk material properties of the implant unaffected while tuning the surface properties. The main components of the coating, i.e. polypeptides and sulfated glycosaminoglycans (sGAG) render this coating both biomimetic (matrix mimetic) and biodegradable. We show how adaptions in the conditions of the multilayer assembly process and the antibiotic loading process affect the amount of delivered gentamicin. The highest concentration of gentamicin could be loaded into films composed of polypeptide poly-glutamic acid when the pH of the loading solution was acidic. The concentration of gentamicin on the surface could be tailored with the number of deposited PEM layers. The resulting coatings reveal a bacteriotoxic effect on Staphylococcus cells but show no signs of cytotoxic effects on MC3T3-E1 osteoblasts. Moreover, when multilayer-coated titanium rods were implanted into contaminated medullae of rat tibiae, a reduction in the development of implant-related osteomyelitis was observed. This reduction was more pronounced for the multifunctional, matrix-mimetic heparin-based coatings that only deliver lower amounts of gentamicin.
Collapse
Affiliation(s)
- Steffi Grohmann
- Institute for Bioprocessing and Analytical Measurement Techniques (iba) e.V., Department of Biomaterials, 37308 Heilbad Heiligenstadt, Germany
| | - Manuela Menne
- Institute for Bioprocessing and Analytical Measurement Techniques (iba) e.V., Department of Biomaterials, 37308 Heilbad Heiligenstadt, Germany
| | - Diana Hesse
- Institute for Bioprocessing and Analytical Measurement Techniques (iba) e.V., Department of Biomaterials, 37308 Heilbad Heiligenstadt, Germany
| | - Sabine Bischoff
- Institute for Laboratory Animal Science and Welfare, University Hospital, 07743 Jena, Germany
| | - René Schiffner
- Orthopaedic Department, University Hospital, 07743 Jena, Germany
| | - Michael Diefenbeck
- Scientific Consulting in Orthopaedic Surgery and Traumatology, 22081 Hamburg, Germany
| | - Klaus Liefeith
- Institute for Bioprocessing and Analytical Measurement Techniques (iba) e.V., Department of Biomaterials, 37308 Heilbad Heiligenstadt, Germany
| |
Collapse
|
14
|
Horbert V, Lange M, Reuter T, Hoffmann M, Bischoff S, Borowski J, Schubert H, Driesch D, Mika J, Hurschler C, Kinne RW. Comparison of Near-Infrared Spectroscopy with Needle Indentation and Histology for the Determination of Cartilage Thickness in the Large Animal Model Sheep. Cartilage 2019; 10:173-185. [PMID: 28980486 PMCID: PMC6425542 DOI: 10.1177/1947603517731851] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The suitability of near-infrared spectroscopy (NIRS) for non-destructive measurement of cartilage thickness was compared with the gold standard needle indentation. A combination of NIRS and biomechanical indentation (NIRS-B) was used to address the influence of varying loads routinely applied for hand-guided NIRS during real-life surgery on the accuracy of NIRS-based thickness prediction. NIRS-B was performed under three different loading conditions in 40 osteochondral cylinders from the load-bearing area of the medial and lateral femur condyle of 20 cadaver joints (left stifle joints; female Merino sheep; 6.1 ± 0.6 years, mean ± standard error of the mean). The cartilage thickness measured by needle indentation within the region analyzed by NIRS-B was then compared with cartilage thickness prediction based on NIRS spectral data using partial least squares regression. NIRS-B repeat measurements yielded highly reproducible values concerning force and absorbance. Separate or combined models for the three loading conditions (the latter simulating load-independent measurements) resulted in models with optimized quality parameters (e.g., coefficients of determination R2 between 92.3 and 94.7) and a prediction accuracy of < 0.1 mm. NIRS appears well suited to determine cartilage thickness (possibly in a hand-guided, load-independent fashion), as shown by high reproducibility in repeat measurements and excellent reliability compared with tissue-destructive needle indentation. This may provide the basis for non-destructive, intra-operative assessment of cartilage status quo and fine-tuning of repair procedures.
Collapse
Affiliation(s)
- Victoria Horbert
- Experimental Rheumatology Unit,
Department of Orthopedics, Jena University Hospital, Waldkrankenhaus “Rudolf Elle”,
Eisenberg, Germany
| | - Matthias Lange
- fzmb GmbH, Research Centre for Medical
Technology and Biotechnology, Bad Langensalza, Germany
| | - Thomas Reuter
- fzmb GmbH, Research Centre for Medical
Technology and Biotechnology, Bad Langensalza, Germany
| | - Martin Hoffmann
- Department of Electrical Engineering and
Information Technology, University of Applied Sciences, Jena, Germany
| | - Sabine Bischoff
- Institute of Laboratory Animal Sciences
and Welfare, Jena University Hospital, Jena, Germany
| | - Juliane Borowski
- Experimental Rheumatology Unit,
Department of Orthopedics, Jena University Hospital, Waldkrankenhaus “Rudolf Elle”,
Eisenberg, Germany
| | - Harald Schubert
- Institute of Laboratory Animal Sciences
and Welfare, Jena University Hospital, Jena, Germany
| | | | - Joerg Mika
- Department of Trauma Surgery, University
Hospital Giessen and Marburg, Giessen, Germany,Laboratory of Experimental Trauma
Surgery, Justus-Liebig University, Giessen, Germany
| | - Christof Hurschler
- Laboratory for Biomechanics and
Biomaterials, Orthopaedic Surgery Department, Hannover Medical School, Hannover,
Germany
| | - Raimund W. Kinne
- Experimental Rheumatology Unit,
Department of Orthopedics, Jena University Hospital, Waldkrankenhaus “Rudolf Elle”,
Eisenberg, Germany,Raimund W. Kinne, MD, Experimental
Rheumatology Unit, Department of Orthopedics, Jena University Hospital,
Waldkrankenhaus “Rudolf Elle”, Klosterlausnitzer Straße 81, 07607 Eisenberg,
Germany.
| |
Collapse
|
15
|
Hettwer W, Horstmann PF, Bischoff S, Güllmar D, Reichenbach JR, Poh PSP, van Griensven M, Gras F, Diefenbeck M. Establishment and effects of allograft and synthetic bone graft substitute treatment of a critical size metaphyseal bone defect model in the sheep femur. APMIS 2019; 127:53-63. [PMID: 30698307 PMCID: PMC6850422 DOI: 10.1111/apm.12918] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 09/26/2018] [Accepted: 12/10/2018] [Indexed: 01/17/2023]
Abstract
Assessment of bone graft material efficacy is difficult in humans, since invasive methods like staged CT scans or biopsies are ethically unjustifiable. Therefore, we developed a novel large animal model for the verification of a potential transformation of synthetic bone graft substitutes into vital bone. The model combines multiple imaging methods with corresponding histology in standardized critical sized cancellous bone defect. Cylindrical bone voids (10 ml) were created in the medial femoral condyles of both hind legs (first surgery at right hind leg, second surgery 3 months later at left hind leg) in three merino‐wool sheep and either (i) left empty, filled with (ii) cancellous allograft bone or (iii) a synthetic, gentamicin eluting bone graft substitute. All samples were analysed with radiographs, MRI, μCT, DEXA and histology after sacrifice at 6 months. Unfilled defects only showed ingrowth of fibrous tissue, whereas good integration of the cancellous graft was seen in the allograft group. The bone graft substitute showed centripetal biodegradation and new trabecular bone formation in the periphery of the void as early as 3 months. μCT gave excellent insight into the structural changes within the defects, particularly progressive allograft incorporation and the bone graft substitute biodegradation process. MRI completed the picture by clearly visualizing soft tissue ingrowth into unfilled bone voids and presence of fluid collections. Histology was essential for verification of trabecular bone and osteoid formation. Conventional radiographs and DEXA could not differentiate details of the ongoing transformation process. This model appears well suited for detailed in vivo and ex vivo evaluation of bone graft substitute behaviour within large bone defects.
Collapse
Affiliation(s)
- Werner Hettwer
- Musculoskeletal Tumor Section, Department of Orthopedic Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Peter F Horstmann
- Musculoskeletal Tumor Section, Department of Orthopedic Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Sabine Bischoff
- Central Experimental Animal Facility, University Hospital Jena, Jena, Germany
| | - Daniel Güllmar
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, University Hospital Jena, Jena, Germany
| | - Jürgen R Reichenbach
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, University Hospital Jena, Jena, Germany
| | - Patrina S P Poh
- Experimental Trauma Surgery, Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Martijn van Griensven
- Experimental Trauma Surgery, Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Florian Gras
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Jena, Jena, Germany
| | - Michael Diefenbeck
- BONESUPPORT AB, Lund, Sweden.,Scientific Consulting in Orthopaedic Surgery and Traumatology, Hamburg, Germany
| |
Collapse
|
16
|
Weinrebe W, Preda R, Bischoff S, Nussbickel D, Humm M, Jeckelmann K, Goetz S. Entscheidungshilfen bei komplexer Polypharmazie. Z Gerontol Geriatr 2018; 51:691-697. [DOI: 10.1007/s00391-017-1285-4] [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] [Received: 03/29/2017] [Revised: 05/23/2017] [Accepted: 06/21/2017] [Indexed: 05/29/2023]
|
17
|
Weber-Spickschen TS, Bischoff S, Horstmann H, Winkelmann M, Mommsen P, Panzica M, Krettek C, Kerling A. [Injury prevention in amateur football with FIFA 11+ : What is implemented on the football pitch?]. Unfallchirurg 2018; 121:463-469. [PMID: 29654512 DOI: 10.1007/s00113-018-0499-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND The warm-up and injury prevention program FIFA 11+ was developed to reduce injuries in recreational and amateur level football. Despite systematic education it is uncertain what amount of knowledge is passed down to the lower recreational level football players and what exercises are implemented in the daily routine. This study presents the summarized experiences of German coaches about the implementation of exercises on the football pitch. MATERIAL AND METHODS In this study 142 coaches who participated in 1 (of 5) of the 2‑day courses between 2013 and 2017 were sent a questionnaire. The questionnaire consisted of 24 questions, which were developed by the football union of Lower Saxony. Incomplete questionnaires were excluded from the study. RESULTS A total of 121 questionnaires could be analyzed, which is a response rate of 85.2%. The mean time period between the 2‑day training and answering the questionnaire was 29 months. Of the participating coaches 82.6% indicated that they use the program regularly (22% of the coaches use it twice a week or more frequently, 34% use it only once a week) and 6% of the coaches use additional programs to prevent injuries. A total of 86% of the participants believed in a reduction in the incidence of injuries induced by the FIFA 11+ concept, 89% of the participants rated the FIFA 11+ program as good ors very good, 91% rated the teaching concept as good or very good and 94% of the participants would recommend the 2‑day advanced course to others. DISCUSSION The prevention program as well as the advanced training concept were evaluated very positively. Most coaches use the program regularly. Nevertheless, many coaches use the FIFA 11+ exercises less than the recommended twice a week. Most coaches praised the good structure of the program, but also wished for the possibility of variations. CONCLUSION The prevention program FIFA 11+ is seen by coaches in recreational and amateur football as an effective tool to prevent injury. Implementation on the football pitch is regular but not as frequent as the evidence-based recommendations in the training concept.
Collapse
Affiliation(s)
- T S Weber-Spickschen
- Sportmedizinisches Institut, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
- Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
| | - S Bischoff
- Sportmedizinisches Institut, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - H Horstmann
- Sportmedizinisches Institut, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - M Winkelmann
- Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - P Mommsen
- Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - M Panzica
- Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - C Krettek
- Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - A Kerling
- Sportmedizinisches Institut, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| |
Collapse
|
18
|
Abstract
AIMS Mechanical right ventricular (RV) support offers a treatment option for critically ill patients with RV failure (RVF). We developed an assist device for rapid percutaneous implantation. The aim of the present study was to investigate the implantation procedure, haemodynamic performance and possible side effects of the novel right ventricular assist device - PERKAT RV - in an animal model. METHODS AND RESULTS The PERkutane KATheterpumptechnologie RV (PERKAT RV) device consists of a nitinol chamber covered by foil containing inflow valves. An outlet tube is attached to its distal part. The system is designed for 18 Fr percutaneous implantation. The chamber is unfolded in the inferior vena cava while the outlet tube bypasses the right heart with the tip in the pulmonary trunk. An IABP balloon is placed inside. Balloon deflation generates blood flow into the chamber; during inflation, blood is guided into the pulmonary arteries. Acute RVF was induced by venous injection of Sephadex in seven sheep for evaluation of the device. The PERKAT RV was able to improve haemodynamics immediately generating a median increase in cardiac output of 59%. Longer pump support was evaluated in a second study. Four sheep were supported for eight hours without any problems. CONCLUSIONS The percutaneous implantation and explantation of the PERKAT RV device was possible in the designed way. The sheep studies proved beneficial haemodynamic effects in acute RVF. The system offers easy and safe treatment in acute RVF.
Collapse
Affiliation(s)
- Daniel Kretzschmar
- Department of Internal Medicine I, University Hospital Jena, Friedrich Schiller University Jena, Jena, Germany
| | | | | | | | | | | |
Collapse
|
19
|
Kender Z, Groener JB, Masjkur JR, Bischoff S, Pflästerer A, Hagedorn-Dambuk A, Nawroth PP, Kopf S. Diabetische sensomotorische Neuropathie der Hände bei Patienten mit Diabetes mellitus Typ 2. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Z Kender
- Medizinische Universitätsklinik Heidelberg, Innere Medizin I Endokrinologie und klinische Chemie, Heidelberg, Germany
| | - JB Groener
- Medizinische Universitätsklinik Heidelberg, Innere Medizin I Endokrinologie und klinische Chemie, Heidelberg, Germany
| | - JR Masjkur
- Medizinische Universitätsklinik Heidelberg, Innere Medizin I Endokrinologie und klinische Chemie, Heidelberg, Germany
| | - S Bischoff
- Medizinische Universitätsklinik Heidelberg, Innere Medizin I Endokrinologie und klinische Chemie, Heidelberg, Germany
| | - A Pflästerer
- Medizinische Universitätsklinik Heidelberg, Innere Medizin I Endokrinologie und klinische Chemie, Heidelberg, Germany
| | - A Hagedorn-Dambuk
- Medizinische Universitätsklinik Heidelberg, Innere Medizin I Endokrinologie und klinische Chemie, Heidelberg, Germany
| | - PP Nawroth
- Medizinische Universitätsklinik Heidelberg, Innere Medizin I Endokrinologie und klinische Chemie, Heidelberg, Germany
| | - S Kopf
- Medizinische Universitätsklinik Heidelberg, Innere Medizin I Endokrinologie und klinische Chemie, Heidelberg, Germany
| |
Collapse
|
20
|
Dreiling M, Schiffner R, Bischoff S, Rupprecht S, Kroegel N, Schubert H, Witte OW, Schwab M, Rakers F. Impact of chronic maternal stress during early gestation on maternal-fetal stress transfer and fetal stress sensitivity in sheep. Stress 2018; 21:1-10. [PMID: 29041862 DOI: 10.1080/10253890.2017.1387534] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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] [Indexed: 10/18/2022] Open
Abstract
Acute stress-induced reduction of uterine blood flow (UBF) is an indirect mechanism of maternal-fetal stress transfer during late gestation. Effects of chronic psychosocial maternal stress (CMS) during early gestation, as may be experienced by many working women, on this stress signaling mechanism are unclear. We hypothesized that CMS in sheep during early gestation augments later acute stress-induced decreases of UBF, and aggravates the fetal hormonal, cardiovascular, and metabolic stress responses during later development. Six pregnant ewes underwent repeated isolation stress (CMS) between 30 and 100 days of gestation (dGA, term: 150 dGA) and seven pregnant ewes served as controls. At 110 dGA, ewes were chronically instrumented and underwent acute isolation stress. The acute stress decreased UBF by 19% in both the CMS and control groups (p < .05), but this was prolonged in CMS versus control ewes (74 vs. 30 min, p < .05). CMS increased fetal circulating baseline and stress-induced cortisol and norepinephrine concentrations indicating a hyperactive hypothalamus-pituitary-adrenal (HPA)-axis and sympathetic-adrenal-medullary system. Increased fetal norepinephrine is endogenous as maternal catecholamines do not cross the placenta. Cortisol in the control but not in the CMS fetuses was correlated with maternal cortisol blood concentrations; these findings indicate: (1) no increased maternal-fetal cortisol transfer with CMS, (2) cortisol production in CMS fetuses when the HPA-axis is normally inactive, due to early maturation of the fetal HPA-axis. CMS fetuses were better oxygenated, without shift towards acidosis compared to the controls, potentially reflecting adaptation to repeated stress. Hence, CMS enhances maternal-fetal stress transfer by prolonged reduction in UBF and increased fetal HPA responsiveness.
Collapse
Affiliation(s)
- Michelle Dreiling
- a Hans Berger Department of Neurology , Jena University Hospital , Jena , Germany
| | - Rene Schiffner
- a Hans Berger Department of Neurology , Jena University Hospital , Jena , Germany
| | - Sabine Bischoff
- b Institute of Lab Animal Sciences and Welfare , Jena University Hospital , Jena , Germany
| | - Sven Rupprecht
- a Hans Berger Department of Neurology , Jena University Hospital , Jena , Germany
| | - Nasim Kroegel
- a Hans Berger Department of Neurology , Jena University Hospital , Jena , Germany
| | - Harald Schubert
- b Institute of Lab Animal Sciences and Welfare , Jena University Hospital , Jena , Germany
| | - Otto W Witte
- a Hans Berger Department of Neurology , Jena University Hospital , Jena , Germany
| | - Matthias Schwab
- a Hans Berger Department of Neurology , Jena University Hospital , Jena , Germany
| | - Florian Rakers
- a Hans Berger Department of Neurology , Jena University Hospital , Jena , Germany
| |
Collapse
|
21
|
Sinn M, Sinn BV, Striefler JK, Lindner JL, Stieler JM, Lohneis P, Bischoff S, Bläker H, Pelzer U, Bahra M, Dietel M, Dörken B, Oettle H, Riess H, Denkert C. SPARC expression in resected pancreatic cancer patients treated with Gemcitabine: results from the CONKO-001 study. Ann Oncol 2017; 28:2900. [PMID: 27578776 DOI: 10.1093/annonc/mdw269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
22
|
Gunnella F, Kunisch E, Bungartz M, Maenz S, Horbert V, Xin L, Mika J, Borowski J, Bischoff S, Schubert H, Hortschansky P, Sachse A, Illerhaus B, Günster J, Bossert J, Jandt KD, Plöger F, Kinne RW, Brinkmann O. Low-dose BMP-2 is sufficient to enhance the bone formation induced by an injectable, PLGA fiber-reinforced, brushite-forming cement in a sheep defect model of lumbar osteopenia. Spine J 2017; 17:1699-1711. [PMID: 28619686 DOI: 10.1016/j.spinee.2017.06.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/23/2017] [Accepted: 06/08/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Bioresorbable calcium phosphate cement (CPC) may be suitable for vertebroplasty/kyphoplasty of osteoporotic vertebral fractures. However, additional targeted delivery of osteoinductive bone morphogenetic proteins (BMPs) in the CPC may be required to counteract the augmented local bone catabolism and support complete bone regeneration. PURPOSE This study aimed at testing an injectable, poly (l-lactide-co-glycolide) acid (PLGA) fiber-reinforced, brushite-forming cement (CPC) containing low-dose bone morphogenetic protein BMP-2 in a sheep lumbar osteopenia model. STUDY DESIGN/ SETTING This is a prospective experimental animal study. METHODS Bone defects (diameter 5 mm) were generated in aged, osteopenic female sheep and filled with fiber-reinforced CPC alone (L4; CPC+fibers) or with CPC containing different dosages of BMP-2 (L5; CPC+fibers+BMP-2; 1, 5, 100, and 500 µg BMP-2; n=5 or 6 each). The results were compared with those of untouched controls (L1). Three and 9 months after the operation, structural and functional effects of the CPC (±BMP-2) were analyzed ex vivo by measuring (1) bone mineral density (BMD); (2) bone structure, that is, bone volume/total volume (assessed by micro-computed tomography [micro-CT] and histomorphometry), trabecular thickness, and trabecular number; (3) bone formation, that is, osteoid volume/bone volume, osteoid surface/bone surface, osteoid thickness, mineralizing surface/bone surface, mineral apposition rate, and bone formation rate/bone surface; (4) bone resorption, that is, eroded surface/bone surface; and (5) compressive strength. RESULTS Compared with untouched controls (L1), CPC+fibers (L4) and/or CPC+fibers+BMP-2 (L5) significantly improved all parameters of bone formation, bone resorption, and bone structure. These effects were observed at 3 and 9 months, but were less pronounced for some parameters at 9 months. Compared with CPC without BMP-2, additional significant effects of BMP-2 were demonstrated for bone structure (bone volume/total volume, trabecular thickness, trabecular number) and formation (osteoid surface/bone surface and mineralizing surface/bone surface), as well as for the compressive strength. The BMP-2 effects on bone formation at 3 and 9 months were dose-dependent, with 5-100 µg as the optimal dosage. CONCLUSIONS BMP-2 significantly enhanced the bone formation induced by a PLGA fiber-reinforced CPC in sheep lumbar osteopenia. A single local dose as low as ≤100 µg BMP-2 was sufficient to augment middle to long-term bone formation. The novel CPC+BMP-2 may thus represent an alternative to the bioinert, supraphysiologically stiff polymethylmethacrylate cement presently used to treat osteoporotic vertebral fractures by vertebroplasty/kyphoplasty.
Collapse
Affiliation(s)
- Francesca Gunnella
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Elke Kunisch
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Matthias Bungartz
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany; Chair of Orthopedics, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Stefan Maenz
- Chair of Materials Science, Otto Schott Institute of Materials Research, Friedrich Schiller University Jena, Löbdergraben 32, 07743 Jena, Germany; Jena Center for Soft Matter (JCSM), Friedrich Schiller University Jena, Humboldtstr. 10, 07743 Jena, Germany
| | - Victoria Horbert
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Long Xin
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Joerg Mika
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Juliane Borowski
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Sabine Bischoff
- Institute of Laboratory Animal Sciences and Welfare, Jena University Hospital, Dornburger Straße 23, 07743 Jena, Germany
| | - Harald Schubert
- Institute of Laboratory Animal Sciences and Welfare, Jena University Hospital, Dornburger Straße 23, 07743 Jena, Germany
| | - Peter Hortschansky
- Leibniz-Institute for Natural Products Research and Infection Biology - Hans-Knoell-Institute, Beutenbergstr. 11a, 07745 Jena, Germany
| | - Andre Sachse
- Chair of Orthopedics, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Bernhard Illerhaus
- Institute of Laboratory Animal Sciences and Welfare, Jena University Hospital, Dornburger Straße 23, 07743 Jena, Germany
| | - Jens Günster
- BAM Bundesanstalt für Materialforschung und -prüfung (BAM), Unter den Eichen 44-46, 12203 Berlin; Germany
| | - Jörg Bossert
- Chair of Materials Science, Otto Schott Institute of Materials Research, Friedrich Schiller University Jena, Löbdergraben 32, 07743 Jena, Germany
| | - Klaus D Jandt
- Chair of Materials Science, Otto Schott Institute of Materials Research, Friedrich Schiller University Jena, Löbdergraben 32, 07743 Jena, Germany; Jena Center for Soft Matter (JCSM), Friedrich Schiller University Jena, Humboldtstr. 10, 07743 Jena, Germany; Jena School for Microbial Communication (JSMC), Friedrich Schiller University Jena, Neugasse 23, 07743 Jena, Germany
| | - Frank Plöger
- BIOPHARM GmbH, Handelsstrasse 15, 69214 Eppelheim, Germany
| | - Raimund W Kinne
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany.
| | - Olaf Brinkmann
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany; Chair of Orthopedics, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| |
Collapse
|
23
|
Sinn M, Budczies J, Damm F, Lohneis P, Schmuck R, Treue D, Striefler J, Bahra M, Pelzer U, Jühling A, Bläker H, Bischoff S, Oettle H, Denkert C, Riess H, Sinn B. TP53 mutation predicts sensitivity to adjuvant gemcitabine in pancreatic cancer: Results from the CONKO-001 study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
24
|
Kretzschmar D, Lauten A, Bischoff S, Schulze P, Ferrari M. P3276a novel right heart assist device-the PERKAT RV system. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
25
|
Laube T, Weisser J, Berger S, Börner S, Bischoff S, Schubert H, Gajda M, Bräuer R, Schnabelrauch M. In situ foamable, degradable polyurethane as biomaterial for soft tissue repair. Mater Sci Eng C Mater Biol Appl 2017; 78:163-174. [PMID: 28575970 DOI: 10.1016/j.msec.2017.04.061] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 04/06/2017] [Accepted: 04/11/2017] [Indexed: 12/12/2022]
Abstract
Degradable foams which can be inserted endoscopically as liquid or pasty mixtures into soft tissue defects possess a promising potential for the surgical treatment of such defects. The defects can be sealed under in situ foaming and simultaneous material expansion. We developed an in situ foamable (l-lactide-co-ε-caprolactone)-based, star-shaped prepolymer by ring opening polymerization of l-lactide and ε-caprolactone in the presence of meso-erythritol as starter. By conversion of the terminal hydroxyl groups of the formed oligoester with lysine diisocyanate ethyl ester (LDI) an isocyanate-endcapped, reactive prepolymer has been received. Foaming can be initiated by addition of 1,4-diazabicyclo[2,2,2]octane (DABCO), water, LDI and DMSO. By varying the composition of these additives, the foaming and curing time could be varied within a clinically acceptable range. A porosity of approximately 90%, and an average tensile strength of 0.3MPa with elongations of 90% were determined for the foams. In vitro cytotoxicity on cured foams was assayed on 3T3 fibroblasts and demonstrated an excellent cytocompatibility. This was also confirmed in an in vivo study using an established rat model, where prefabricated foams and in situ hardening material were inserted into subdermal skin incisions in parallel. The feature of chronic inflammation was only weakly developed in both groups and slightly more pronounced and persisted for longer time in the group of in situ foamed material. In both groups the foreign materials were vascularized, degraded and substituted by connective tissue. The results encourage to proceed with trials where the materials are used to fill more heavily loaded defects.
Collapse
Affiliation(s)
| | | | - Stefan Berger
- INNOVENT e.V., Biomaterials Department, Jena, Germany
| | - Stefan Börner
- Institute of Materials Science and Technology, Friedrich Schiller University Jena, Jena, Germany
| | - Sabine Bischoff
- Institute of Animal Research and Protection, University Hospital Jena, Jena, Germany
| | - Harald Schubert
- Institute of Animal Research and Protection, University Hospital Jena, Jena, Germany
| | | | - Rolf Bräuer
- Institute of Pathology, University Hospital Jena, Jena, Germany
| | | |
Collapse
|
26
|
Barazzoni R, Deutz N, Biolo G, Bischoff S, Boirie Y, Cederholm T, Cuerda C, Delzenne N, Leon Sanz M, Ljungqvist O, Muscaritoli M, Pichard C, Preiser J, Sbraccia P, Singer P, Tappy L, Thorens B, Van Gossum A, Vettor R, Calder P. Carbohydrates and insulin resistance in clinical nutrition: Recommendations from the ESPEN expert group. Clin Nutr 2017; 36:355-363. [DOI: 10.1016/j.clnu.2016.09.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/13/2016] [Accepted: 09/13/2016] [Indexed: 12/17/2022]
|
27
|
Bothe W, Diab M, Ostermann R, Schwarzer M, Woelfel L, Bischoff S, Schubert H, Doenst T. Surgical access via right thoracotomy facilitates tricuspid valve surgery in sheep. J Vet Sci 2017; 18:67-71. [PMID: 27456775 PMCID: PMC5366304 DOI: 10.4142/jvs.2017.18.1.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 04/27/2016] [Accepted: 06/08/2016] [Indexed: 11/20/2022] Open
Abstract
In quadrupeds, the three-dimensional orientation of the heart with respect to the thorax is fundamentally different from that in humans. In this study, we assessed the best surgical approach to the tricuspid valve in sheep. Firstly, different surgical access sites to the tricuspid valve were tested in sheep cadavers, the anatomy was analyzed, and the optimal surgical approach to the tricuspid valve was determined. Secondly - along with cardiopulmonary bypass and cardioplegic arrest -the chosen approach was tested in six adult sheep in vivo. Anatomical analyses revealed that a left thoracotomy provided optimal access to the aorta and left heart. However, visualization of the right heart was significantly impaired. In contrast, a right thoracotomy provided good access to the right heart, but the ascending aorta was difficult to approach. Therefore, in the in vivo studies, arterial cannulation was performed through a carotid (n = 4) or femoral (n = 2) artery. In conclusion, a right-sided thoracotomy allows good visualization of all components of the tricuspid valve complex in sheep, but not of the ascending aorta. Consequently, peripheral vessels are preferred for arterial cannulation. This work may stimulate the investigation of pathomechanisms and/or novel treatment options for tricuspid valve pathologies.
Collapse
Affiliation(s)
- Wolfgang Bothe
- Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University, Jena 07747, Germany.,Department of Cardiovascular Surgery, Heart Center, University of Freiburg, Freiburg 79110, Germany
| | - Mahmoud Diab
- Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University, Jena 07747, Germany
| | - Romanus Ostermann
- Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University, Jena 07747, Germany
| | - Michael Schwarzer
- Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University, Jena 07747, Germany
| | - Luisa Woelfel
- Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University, Jena 07747, Germany
| | - Sabine Bischoff
- Institute of Laboratory Animals Science and Welfare, Jena University Hospital, Friedrich Schiller University, Jena 07747, Germany
| | - Harald Schubert
- Institute of Laboratory Animals Science and Welfare, Jena University Hospital, Friedrich Schiller University, Jena 07747, Germany
| | - Torsten Doenst
- Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University, Jena 07747, Germany
| |
Collapse
|
28
|
Hauner H, Moss A, Berg A, Bischoff S, Colombo-Benkmann M, Ellrott T, Kanthak U, Kunze D, Stefan N, Teufel M, Wabitsch M, Wirth A. Prävention und Therapie der Adipositas. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0042-114746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- H. Hauner
- Klinik für Ernährungsmedizin, Klinikum rechts der Isar, Technische Universität München
| | - A. Moss
- Universitätsklinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Ulm
| | - A. Berg
- Institut für Sport und Sportwissenschaft der Universität Freiburg, Freiburg
| | - S. Bischoff
- Institut für Ernährungsmedizin, Universität Hohenheim, Stuttgart
| | | | - T. Ellrott
- Institut für Ernährungspsychologie, Georg-August-Universität, Göttingen
| | - U. Kanthak
- Adipositaschirurgie Selbsthilfe Deutschland e. V
| | - D. Kunze
- Kinderendokrinologische Praxis, München
| | - N. Stefan
- Institute of Diabetes Research and Metabolic Diseases IDM, Universitätsklinikum Tübingen
| | - M. Teufel
- Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
| | - M. Wabitsch
- Universitätsklinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Ulm
| | | |
Collapse
|
29
|
Heinritz SN, Weiss E, Eklund M, Aumiller T, Messner S, Heyer CME, Bischoff S, Mosenthin R. 0952 Intestinal microbiota, microbial metabolites and carcass traits are changed in a pig model fed a high-fat/low-fiber or a low-fat/high-fiber diet. J Anim Sci 2016. [DOI: 10.2527/jam2016-0952] [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
|
30
|
Bungartz M, Maenz S, Kunisch E, Horbert V, Xin L, Gunnella F, Mika J, Borowski J, Bischoff S, Schubert H, Sachse A, Illerhaus B, Günster J, Bossert J, Jandt KD, Kinne RW, Brinkmann O. First-time systematic postoperative clinical assessment of a minimally invasive approach for lumbar ventrolateral vertebroplasty in the large animal model sheep. Spine J 2016; 16:1263-1275. [PMID: 27345746 DOI: 10.1016/j.spinee.2016.06.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 05/20/2016] [Accepted: 06/21/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND CONTEXT Large animal models are highly recommended for meaningful preclinical studies, including the optimization of cement augmentation for vertebral body defects by vertebroplasty/kyphoplasty. PURPOSE The aim of this study was to perform a systematic characterization of a strictly minimally invasive in vivo large animal model for lumbar ventrolateral vertebroplasty. STUDY DESIGN/ SETTING This is a prospective experimental animal study. METHODS Lumbar defects (diameter 5 mm; depth approximately 14 mm) were created by a ventrolateral percutaneous approach in aged, osteopenic, female sheep (40 Merino sheep; 6-9 years; 68-110 kg). L1 remained untouched, L2 was left with an empty defect, and L3 carried a defect injected with a brushite-forming calcium phosphate cement (CPC). Trauma/functional impairment, surgical techniques (including drill sleeve and working canula with stop), reproducibility, bone defects, cement filling, and functional cement augmentation were documented by intraoperative incision-to-suture time and X-ray, postoperative trauma/impairment scores, and ex vivo osteodensitometry, microcomputed tomography (CT), histology, static/fluorescence histomorphometry, and biomechanical testing. RESULTS Minimally invasive vertebroplasty resulted in short operation times (28±2 minutes; mean±standard error of the mean) and X-ray exposure (1.59±0.12 minutes), very limited local trauma (score 0.00±0.00 at 24 hours), short postoperative recovery (2.95±0.29 hours), and rapid decrease of the postoperative impairment score to 0 (3.28±0.36 hours). Reproducible defect creation and cement filling were documented by intraoperative X-ray and ex vivo conventional/micro-CT. Vertebral cement augmentation and osteoconductivity of the CPC was verified by osteodensitometry (CPC>control), micro-CT (CPC>control and empty defect), histology/static histomorphometry (CPC>control and empty defect), fluorescence histomorphometry (CPC>control; all p<.05 for 3 and 9 months), and compressive strength measurements (CPC numerically higher than control; 102% for 3 months and 110% for 9 months). CONCLUSIONS This first-time systematic clinical assessment of a minimally invasive, ventrolateral, lumbar vertebroplasty model in aged, osteopenic sheep resulted in short operation times, rapid postoperative recovery, and high experimental reproducibility. This model represents an optimal basis for standardized evaluation of future studies on vertebral augmentation with resorbable and osteoconductive CPC.
Collapse
Affiliation(s)
- Matthias Bungartz
- Chair of Orthopedics, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle," Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany; Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany.
| | - Stefan Maenz
- Chair of Materials Science, Otto Schott Institute of Materials Research, Friedrich Schiller University Jena, Löbdergraben 32, D-07743 Jena, Germany; Jena School for Microbial Communication (JSMC), Friedrich Schiller University Jena, Neugasse 23, D-07743 Jena, Germany
| | - Elke Kunisch
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany
| | - Victoria Horbert
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany
| | - Long Xin
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany
| | - Francesca Gunnella
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany
| | - Joerg Mika
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany
| | - Juliane Borowski
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany
| | - Sabine Bischoff
- Institute of Laboratory Animal Sciences and Welfare, Jena University Hospital, Dornburger Str. 23, D-07743 Jena, Germany
| | - Harald Schubert
- Institute of Laboratory Animal Sciences and Welfare, Jena University Hospital, Dornburger Str. 23, D-07743 Jena, Germany
| | - Andre Sachse
- Chair of Orthopedics, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle," Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany
| | - Bernhard Illerhaus
- BAM Bundesanstalt für Materialforschung und - prüfung (BAM), Unter den Eichen 87, D-12205 Berlin, Germany
| | - Jens Günster
- BAM Bundesanstalt für Materialforschung und - prüfung (BAM), Unter den Eichen 87, D-12205 Berlin, Germany
| | - Jörg Bossert
- Chair of Materials Science, Otto Schott Institute of Materials Research, Friedrich Schiller University Jena, Löbdergraben 32, D-07743 Jena, Germany
| | - Klaus D Jandt
- Chair of Materials Science, Otto Schott Institute of Materials Research, Friedrich Schiller University Jena, Löbdergraben 32, D-07743 Jena, Germany; Jena School for Microbial Communication (JSMC), Friedrich Schiller University Jena, Neugasse 23, D-07743 Jena, Germany; Jena Center for Soft Matter (JCSM), Friedrich Schiller University Jena, Humboldstr. 10, D-07743 Jena, Germany
| | - Raimund W Kinne
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany
| | - Olaf Brinkmann
- Chair of Orthopedics, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle," Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany; Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany
| |
Collapse
|
31
|
Dreiling M, Bischoff S, Schiffner R, Rupprecht S, Kiehntopf M, Schubert H, Witte OW, Nathanielsz PW, Schwab M, Rakers F. Stress-induced decrease of uterine blood flow in sheep is mediated by alpha 1-adrenergic receptors. Stress 2016; 19:547-51. [PMID: 27352901 DOI: 10.1080/10253890.2016.1203417] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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] [Indexed: 10/21/2022] Open
Abstract
Prenatal maternal stress can be transferred to the fetus via a catecholamine-dependent decrease of uterine blood flow (UBF). However, it is unclear which group of adrenergic receptors mediates this mechanism of maternal-fetal stress transfer. We hypothesized that in sheep, alpha 1-adrenergic receptors may play a key role in catecholamine mediated UBF decrease, as these receptors are mainly involved in peripheral vasoconstriction and are present in significant number in the uterine vasculature. After chronic instrumentation at 125 ± 1 days of gestation (dGA; term 150 dGA), nine pregnant sheep were exposed at 130 ± 1 dGA to acute isolation stress for one hour without visual, tactile, or auditory contact with their flockmates. UBF, blood pressure (BP), heart rate (HR), stress hormones, and blood gases were determined before and during this isolation challenge. Twenty-four hours later, experiments were repeated during alpha 1-adrenergic receptor blockage induced by a continuous intravenous infusion of urapidil. In both experiments, ewes reacted to isolation with an increase in serum norepinephrine, cortisol, BP, and HR as typical signs of activation of sympatho-adrenal and the hypothalamic-pituitary-adrenal axis. Stress-induced UBF decrease was prevented by alpha 1-adrenergic receptor blockage. We conclude that UBF decrease induced by maternal stress in sheep is mediated by alpha 1-adrenergic receptors. Future studies investigating prevention strategies of impact of prenatal maternal stress on fetal health should consider selective blockage of alpha 1-receptors to interrupt maternal-fetal stress transfer mediated by utero-placental malperfusion.
Collapse
Affiliation(s)
- Michelle Dreiling
- a Hans Berger Department of Neurology , Jena University Hospital , Jena , Germany
| | - Sabine Bischoff
- b Institute of Lab Animal Sciences and Welfare, Jena University Hospital , Jena , Germany
| | - Rene Schiffner
- a Hans Berger Department of Neurology , Jena University Hospital , Jena , Germany
| | - Sven Rupprecht
- a Hans Berger Department of Neurology , Jena University Hospital , Jena , Germany
| | - Michael Kiehntopf
- c Institute of Clinical Chemistry and Laboratory Medicine, Jena University Hospital , Jena , Germany
| | - Harald Schubert
- b Institute of Lab Animal Sciences and Welfare, Jena University Hospital , Jena , Germany
| | - Otto W Witte
- a Hans Berger Department of Neurology , Jena University Hospital , Jena , Germany
- d Center for Sepsis Control and Care, Jena University Hospital , Jena , Germany
| | | | - Matthias Schwab
- a Hans Berger Department of Neurology , Jena University Hospital , Jena , Germany
| | - Florian Rakers
- a Hans Berger Department of Neurology , Jena University Hospital , Jena , Germany
| |
Collapse
|
32
|
Huscher D, Albrecht K, Bischoff S, Thiele K, Behrens F, Hoese G, Ochs W, Zink A. AB0726 Severe Obesity Is Frequent in Patients with Psoriatic Arthritis and Is Accompanied by Increased Cardiovascular Risk. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
33
|
Striefler J, Wislocka L, Sinn M, Pelzer U, Denkert C, Juehling A, Bischoff S, Bahra M, Hendrik B, Oettle H, Riess H, Lohneis P. PD-007 CXCR4, CXCR7 and CXCL12 expression is not a prognostic predictive factor in patients with resected pancreatic cancer - results from the CONKO-001 trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw200.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
34
|
Hauner H, Moss A, Berg A, Bischoff S, Colombo-Benkmann M, Ellrott T, Kanthak U, Kunze D, Stefan N, Teufel M, Wabitsch M, Wirth A. Prävention und Therapie der Adipositas. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1553575] [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: 10/22/2022]
Affiliation(s)
- H. Hauner
- Institut für Ernährungsmedizin, Klinikum rechts der Isar, Technische Universität München
| | - A. Moss
- Universitätsklinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Ulm
| | - A. Berg
- Institut für Sport und Sportwissenschaft der Universität Freiburg, Freiburg
| | - S. Bischoff
- Institut für Ernährungsmedizin, Universität Hohenheim, Stuttgart
| | | | - T. Ellrott
- Institut für Ernährungspsychologie, Georg-August-Universität, Göttingen
| | - U. Kanthak
- Adipositaschirurgie Selbsthilfe Deutschland e. V
| | - D. Kunze
- Kinderendokrinologische Praxis, München
| | - N. Stefan
- Institute of Diabetes Research and Metabolic Diseases IDM, Universitätsklinikum Tübingen
| | - M. Teufel
- Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
| | - M. Wabitsch
- Universitätsklinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Ulm
| | | |
Collapse
|
35
|
Arends J, Bertz H, Bischoff S, Fietkau R, Herrmann H, Holm E, Horneber M, Hütterer E, Körber J, Schmid I. S3-Leitline der Deutschen Gesellschaft für Ernährungsmedizin e. V. (DGEM) in Kooperation mit der Deutschen Gesellschaft für Hämatologie und Onkologie e. V. (DGHO), der Arbeitsgemeinschaft „Supportive Maßnahmen in der Onkologie, Rehabilitation und Sozialmedizin“ der Deutschen Krebsgesellschaft (ASORS) und der Österreichischen Arbeitsgemeinschaft für klinische Ernährung (AKE). Aktuel Ernahrungsmed 2015. [DOI: 10.1055/s-0035-1552741] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- J. Arends
- Klinik für Tumorbiologie, Freiburg im Breisgau
| | - H. Bertz
- Klinik Innere Medizin I, Universitätsklinik, Hämatologie/Onkologie/Stammzelltransplantation, Sektion Ernährungsmedizin, Freiburg
| | - S. Bischoff
- Institut für Ernährungsmedizin, Universität Hohenheim, Stuttgart
| | - R. Fietkau
- Strahlenklinik, Universitätsklinikum Erlangen
| | - H. Herrmann
- Klinische und Experimentelle Ernährungsmedizin, Medizinische Klinik 1, Universitätsklinikum Erlangen
| | - E. Holm
- Universitätsklinikum Mannheim
| | - M. Horneber
- Klinik für Innere Medizin 5, Schwerpunkt Onkologie/Hämatologie, Paracelsus Medizinische Privatuniversität, Klinikum Nürnberg
| | - E. Hütterer
- Universitätsklinik für Innere Med. I, Onkologie 6i, Wien
| | - J. Körber
- Hamm-Kliniken GmbH & Co. KG, Klinik Nahetal, Bad Kreuznach
| | - I. Schmid
- Dr. von Haunersches Kinderspital, Klinikum der Universität München
| | | |
Collapse
|
36
|
Rakers F, Bischoff S, Schiffner R, Haase M, Rupprecht S, Kiehntopf M, Kühn-Velten WN, Schubert H, Witte OW, Nijland MJ, Nathanielsz PW, Schwab M. Role of catecholamines in maternal-fetal stress transfer in sheep. Am J Obstet Gynecol 2015. [PMID: 26212181 DOI: 10.1016/j.ajog.2015.07.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We sought to evaluate whether in addition to cortisol, catecholamines also transfer psychosocial stress indirectly to the fetus by decreasing uterine blood flow (UBF) and increasing fetal anaerobic metabolism and stress hormones. STUDY DESIGN Seven pregnant sheep chronically instrumented with uterine ultrasound flow probes and catheters at 0.77 gestation underwent 2 hours of psychosocial stress by isolation. We used adrenergic blockade with labetalol to examine whether decreased UBF is catecholamine mediated and to determine to what extent stress transfer from mother to fetus is catecholamine dependent. RESULTS Stress induced transient increases in maternal cortisol and norepinephrine (NE). Maximum fetal plasma cortisol concentrations were 8.1 ± 2.1% of those in the mother suggesting its maternal origin. In parallel to the maternal NE increase, UBF decreased by maximum 22% for 30 minutes (P < .05). Fetal NE remained elevated for >2 hours accompanied by a prolonged blood pressure increase (P < .05). Fetuses developed a delayed and prolonged shift toward anaerobic metabolism in the presence of an unaltered oxygen supply. Adrenergic blockade prevented the stress-induced UBF decrease and, consequently, the fetal NE and blood pressure increase and the shift toward anaerobic metabolism. CONCLUSION We conclude that catecholamine-induced decrease of UBF is a mechanism of maternal-fetal stress transfer. It may explain the influence of maternal stress on fetal development and on programming of adverse health outcomes in later life especially during early pregnancy when fetal glucocorticoid receptor expression is limited.
Collapse
Affiliation(s)
- Florian Rakers
- Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany.
| | - Sabine Bischoff
- Institute of Laboratory Animal Sciences and Welfare, Jena University Hospital, Jena, Germany
| | - Rene Schiffner
- Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany
| | - Michelle Haase
- Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany
| | - Sven Rupprecht
- Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany
| | - Michael Kiehntopf
- Institute of Clinical Chemistry and Laboratory Medicine, Jena University Hospital, Jena, Germany
| | | | - Harald Schubert
- Institute of Laboratory Animal Sciences and Welfare, Jena University Hospital, Jena, Germany
| | - Otto W Witte
- Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany; Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany
| | - Mark J Nijland
- Center for Pregnancy and Newborn Research, Department of Obstetrics and Gynecology, University of Texas, San Antonio, School of Medicine, San Antonio, TX
| | - Peter W Nathanielsz
- Center for Pregnancy and Newborn Research, Department of Obstetrics and Gynecology, University of Texas, San Antonio, School of Medicine, San Antonio, TX
| | - Matthias Schwab
- Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany
| |
Collapse
|
37
|
Bischoff S. Adipositas im Erwachsenenalter. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1553516] [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]
Affiliation(s)
- S. Bischoff
- Institut für Ernährungsmedizin, Universität Hohenheim
| |
Collapse
|
38
|
Klek S, Chourdakis M, Bischoff S, Dubrov S, Forbes A, Galas A, Genton L, Gundogdu H, Irtun O, Jagmane I, Jirka A, Jakobson-Forbes T, Kennedy N, Klimasauskas A, Khoroshilov I, Leon-Sanz M, Muscaritoli M, Panisic-Sekeljic M, Poulia K, Schneider S, Siljamäki-Ojansuu U, Uyar M, Wanten G, Krznaric Z. SUN-PP013: Reimbursement Affects Prescription of Enteral and Parenteral Nutrition? Results from European Multicenter Survey. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30164-3] [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: 11/16/2022]
|
39
|
Foerster G, Arnold D, Bischoff S, Boltze K, Scholle HC, Schubert H, Mueller AH. Pre-clinical evaluation of a minimally invasive laryngeal pacemaker system in mini-pig. Eur Arch Otorhinolaryngol 2015; 273:151-8. [PMID: 26264908 DOI: 10.1007/s00405-015-3735-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 07/21/2015] [Indexed: 11/25/2022]
Abstract
Microlaryngoscopic enlargement techniques have been the standard treatment for bilateral vocal fold paralysis (BVFP) for decades. Laryngeal pacing is a promising alternative treatment based on the electrostimulation of the posterior cricoarytenoid (PCA) muscle. This paper reports on the results of a pre-clinical study aiming to evaluate this method. Eight Göttingen mini-pigs were implanted with a laryngeal pacemaker (LP) implant prototype and with two LP electrodes, one in each PCA muscle. The 6-week follow-up included endoscopic stimulation controls in general anaesthesia and radiographic controls of electrode integrity and position stability. Stimulation parameters for optimal glottal opening were evaluated via videolaryngoscopy. Histopathology was performed upon conclusion of the study. 7/8 (87.5 %) animals were successfully implanted with the LP implant prototype and two LP electrodes. In general, stimulation was effectively delivered and correlated with the expected PCA muscle activation. 2/14 (14.3 %) electrodes dislocated and 1/14 (7.1 %) electrode tip broke. The LP system used in this experiment to induce vocal fold abduction by means of selective functional electrical stimulation of the PCA showed promising results. It may be a valid alternative to the current golden standard for BVFP treatment. Clinical studies are needed to confirm the medical relevance of the LP.
Collapse
Affiliation(s)
- Gerhard Foerster
- Department Otorhinolaryngology, SRH Wald-Klinikum Gera, 07548, Gera, Germany.
| | - Dirk Arnold
- Section for Motor Research, Pathophysiology and Biomechanics of University Hospital for Trauma-, Hand- and Reconstructive Surgery, Friedrich-Schiller-University Jena, Jena, Germany
| | - Sabine Bischoff
- Institute for Laboratory Animal Sciences and Welfare of Friedrich-Schiller-University Jena, Jena, Germany
| | - Karsten Boltze
- Department of Pathology, SRH Wald-Klinikum Gera, Gera, Germany
| | - Hans-Christoph Scholle
- Section for Motor Research, Pathophysiology and Biomechanics of University Hospital for Trauma-, Hand- and Reconstructive Surgery, Friedrich-Schiller-University Jena, Jena, Germany
| | - Harald Schubert
- Institute for Laboratory Animal Sciences and Welfare of Friedrich-Schiller-University Jena, Jena, Germany
| | - Andreas H Mueller
- Department Otorhinolaryngology, SRH Wald-Klinikum Gera, 07548, Gera, Germany
| |
Collapse
|
40
|
Albrecht K, Huscher D, Aringer M, Bischoff S, Hoese G, Ochs W, Thiele K, Zink A. THU0351 Current Smoking is a Risk Factor for Giant Cell Arteritis in Patients with Polymyalgia Rheumatica. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3756] [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: 11/04/2022]
|
41
|
Hauner H, Moss A, Berg A, Bischoff S, Colombo-Benkmann M, Ellrott T, Kanthak U, Kunze D, Stefan N, Teufel M, Wabitsch M, Wirth A. Prävention und Therapie der Adipositas. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0034-1385404] [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: 10/24/2022]
Affiliation(s)
- H. Hauner
- Institut für Ernährungsmedizin, Klinikum rechts der Isar, Technische Universität München
| | - A. Moss
- Universitätsklinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Ulm
| | - A. Berg
- Institut für Sport und Sportwissenschaft der Universität Freiburg, Freiburg
| | - S. Bischoff
- Institut für Ernährungsmedizin, Universität Hohenheim, Stuttgart
| | | | - T. Ellrott
- Institut für Ernährungspsychologie, Georg-August-Universität, Göttingen
| | - U. Kanthak
- Adipositaschirurgie Selbsthilfe Deutschland e. V
| | - D. Kunze
- Kinderendokrinologische Praxis, München
| | - N. Stefan
- Institute of Diabetes Research and Metabolic Diseases IDM, Universitätsklinikum Tübingen
| | - M. Teufel
- Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
| | - M. Wabitsch
- Universitätsklinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Ulm
| | | |
Collapse
|
42
|
Felber J, Aust D, Baas S, Bischoff S, Bläker H, Daum S, Keller R, Koletzko S, Laass M, Nothacker M, Roeb E, Schuppan D, Stallmach A. [Results of a S2k-Consensus Conference of the German Society of Gastroenterolgy, Digestive- and Metabolic Diseases (DGVS) in conjunction with the German Coeliac Society (DZG) regarding coeliac disease, wheat allergy and wheat sensitivity]. Z Gastroenterol 2014; 52:711-43. [PMID: 25026010 DOI: 10.1055/s-0034-1366687] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- J Felber
- Klinik für Innere Medizin IV, Universitätsklinikum der Friedrich-Schiller-Universität Jena
| | - D Aust
- Institut für Pathologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden
| | - S Baas
- Deutsche Zöliakie-Gesellschaft e. V. (DZG), Stuttgart
| | - S Bischoff
- Institut für Ernährungsmedizin, Universität Hohenheim, Stuttgart
| | - H Bläker
- Institut für Pathologie, Charité, Universitätsmedizin Berlin
| | - S Daum
- Medizinische Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Charité, Universitätsmedizin Berlin
| | - R Keller
- Medizinische Klinik II, Gastroenterologie, Onkologie, Klinikum Aschaffenburg
| | - S Koletzko
- Dr. von Hauner Kinderspital, Klinikum der Universität München Campus Innenstadt, Ludwig-Maximilians-Universität München
| | - M Laass
- Klinik und Poliklinik für Kinder und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - M Nothacker
- Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e. V. (AWMF), Philipps-Universität, Marburg
| | - E Roeb
- Medizinische Klinik II, Abteilung für Gastroenterologie, Universitätsklinikum Gießen und Marburg, Standort Gießen
| | | | | |
Collapse
|
43
|
Albrecht K, Huscher D, Bischoff S, Thiele K, Backhaus M, Richter J, Kötter I, Zink A. FRI0411 Ongoing Pain despite Improved Disease Activity in Patients with Systemic Lupus Erythematodes: A Comparison of Two SLE Cohorts in Germany in the 1990S and the 2000S:. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2223] [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: 11/03/2022]
|
44
|
Huscher D, Albrecht K, Bischoff S, Thiele K, Krause A, Späthling-Mestekemper S, Wassenberg S, Zink A. THU0443 Increasing Disparities between Physician Assessment of Disease Activity and Patient Global Health in Germany between 2000 and 2012. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
45
|
Bischoff S, Koletzko B, Lochs H, Meier R. S3-Leitlinie der Deutschen Gesellschaft für Ernährungsmedizin (DGEM) in Zusammenarbeit mit der Gesellschaft für klinische Ernährung der Schweiz (GESKES), der Österreichischen Arbeitsgemeinschaft für klinische Ernährung (AKE) und der Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS). Aktuel Ernahrungsmed 2014. [DOI: 10.1055/s-0034-1370084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- S. Bischoff
- Universität Hohenheim, Institut für Ernährungsmedizin, Stuttgart, Deutschland
| | - B. Koletzko
- Dr. von Haunersches Kinderspital Kinderklinik und Kinderpoliklinik der Ludwig Maximilian Universität München, Abteilung für Stoffwechsel und Ernährung, München, Deutschland
| | - H. Lochs
- Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - R. Meier
- Medizinische Universitätsklinik, Kantonsspital Baselland, Abteilung für Gastroenterologie, Hepatologie und Ernährung, Liestal, Schweiz
| | | |
Collapse
|
46
|
Sinn M, Sinn BV, Striefler JK, Lindner JL, Stieler JM, Lohneis P, Bischoff S, Bläker H, Pelzer U, Bahra M, Dietel M, Dörken B, Oettle H, Riess H, Denkert C. SPARC expression in resected pancreatic cancer patients treated with gemcitabine: results from the CONKO-001 study. Ann Oncol 2014; 25:1025-32. [PMID: 24562449 DOI: 10.1093/annonc/mdu084] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Previous investigations in pancreatic cancer suggested a prognostic role for secreted protein acidic and rich in cysteine (SPARC) expression in the peritumoral stroma but not for cytoplasmic SPARC expression. The aim of this study was to evaluate the impact of SPARC expression in pancreatic cancer patients treated with gemcitabine compared with untreated patients. PATIENTS AND METHODS CONKO-001 was a prospective randomized phase III study investigating the role of adjuvant gemcitabine when compared with observation. Tissue samples of 160 patients were available for SPARC immunohistochemistry on tissue microarrays to evaluate its impact on patient outcome. RESULTS Strong stromal SPARC expression was associated with worse disease-free survival (DFS) and overall survival (OS) in the overall study population (DFS: P = 0.005, OS: P = 0.033). Its negative prognostic impact was restricted to patients treated with gemcitabine (DFS: P = 0.007, OS: P = 0.006). High cytoplasmic SPARC expression also was associated with worse patient outcome (DFS: P = 0.041, OS: P = 0.011). Again the effect was restricted to patients treated with gemcitabine (DFS: P = 0.002, OS: P = 0.003). In multivariable analysis, SPARC expression was independently predictive of patient outcome. CONCLUSIONS Our data confirm the prognostic significance of SPARC expression after curatively intended resection. The negative prognostic impact was restricted to patients who received adjuvant treatment with gemcitabine, suggesting SPARC as a predictive marker for response to gemcitabine.
Collapse
Affiliation(s)
- M Sinn
- Department of Medical Oncology and Haematology
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Lauten A, Laube A, Schubert H, Bischoff S, Nietzsche S, Horstkötter K, Poudel-Bochmann B, Franz M, Lichtenberg A, Figulla HR, Akhyari P. Transcatheter treatment of tricuspid regurgitation by caval valve implantation--experimental evaluation of decellularized tissue valves in central venous position. Catheter Cardiovasc Interv 2014; 85:150-60. [PMID: 24403276 DOI: 10.1002/ccd.25380] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 01/01/2014] [Indexed: 11/05/2022]
Abstract
BACKGROUND Caval valve implantation has been suggested for transcatheter treatment of severe tricuspid regurgitation (TR). Combining the interventional technique with the promising surgical experience with decellularized valves, we sought to evaluate the functional and structural outcome of decellularized pericardial tissue valves (dTVs) in the low-pressure venous circulation in a chronic model of TR. METHODS AND RESULTS Sixteen pericardial tissue valves were heterotopically implanted in the inferior and superior vena cava in a sheep model (54-98 kg; median 74.5 kg, n = 8) of severe TR. The devices were assembled using self-expanding nitinol stents and bovine pericardia decellularized by a detergent-based protocol (group dTV; n = 8). Glutaraldehyde-fixed pericardial tissue valves served as control (GaTV, n = 8). After 6 months, device function and structural maturation were analyzed using echocardiographic, histologic, immunohistologic, and electron microscopic approaches. After implantation, cardiac output increased significantly from 3.7 ± 1.1 l/min to 4.8 ± 1.1 l/min (P < 0.05) and competent valve function was verified by angiography. At 6 months, angiographic and echocardiographic evaluation revealed moderate to severe regurgitation in all GaTV. In contrast, five of the eight dTVs functioned well with only minor regurgitation. In these animals, autopsy revealed preserved valve structure with tender leaflets without signs of thrombosis or calcification. Conversely, GaTV showed severe degeneration with large calcification areas. Microscopic and histologic analysis confirmed endothelial repopulation in both valve types. However, additional interstitial reseeding was observed in decellularized valves. CONCLUSIONS In the venous circulation in severe TR, decellularized valves show superior functional performance compared to Ga-fixed tissue valves. Macroscopic and microscopic analyses suggest preserved structural integrity and advanced endothelial and interstitial repopulation with evidence of less degradation in dTV. © 2014 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Alexander Lauten
- Department of Internal Medicine I (Cardiology, Angiology, Pneumology, Intensive Care Medicine), University Heart Center, Friedrich-Schiller-University, Jena, Germany
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Wolfram F, Boltze C, Schubert H, Bischoff S, Lesser TG. Effect of lung flooding and high-intensity focused ultrasound on lung tumours: an experimental study in an ex vivo human cancer model and simulated in vivo tumours in pigs. Eur J Med Res 2014; 19:1. [PMID: 24393333 PMCID: PMC3892005 DOI: 10.1186/2047-783x-19-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 12/19/2013] [Indexed: 12/19/2022] Open
Abstract
Background High-intensity focused ultrasound is a valuable tool for minimally invasive tumour ablation. However, due to the air content in ventilated lungs, lung tumours have never been treated with high-intensity focused ultrasound. Lung flooding enables efficient lung sonography and tumour imaging in ex vivo human and in vivo porcine lung cancer models. The current study evaluates the effectiveness of lung flooding and sonography-guided high-intensity focused ultrasound for lung tumour ablation in ex vivo human and in vivo animal models. Methods Lung flooding was performed in four human lung lobes which were resected from non-small cell lung cancers. B-mode imaging and temperature measurements were simultaneously obtained during high-intensity focused ultrasonography of centrally located lung cancers. The tumour was removed immediately following insonation and processed for nicotinamide adenine dinucleotide phosphate-diaphorase and H&E staining. In addition, the left lungs of three pigs were flooded. Purified BSA in glutaraldehyde was injected centrally into the left lower lung lobe to simulate a lung tumour. The ultrasound was focused transthoracically through the flooded lung into the simulated tumour with the guidance of sonography. The temperature of the tumour was simultaneously measured. The vital signs of the animal were monitored during the procedure. Results A well-demarcated lesion of coagulation necrosis was produced in four of four human lung tumours. There did not appear to be any damage to the surrounding lung parenchyma. After high-intensity focused ultrasound insonation, the mean temperature increase was 7.5-fold higher in the ex vivo human tumour than in the flooded lung tissue (52.1 K ± 8.77 K versus 7.1 K ± 2.5 K). The transthoracic high-intensity focused ultrasound of simulated tumours in the in vivo model resulted in a mean peak temperature increase up to 53.7°C (±4.5). All of the animals survived the procedure without haemodynamic complications. Conclusions High-intensity focused ultrasound with lung flooding produced a thermal effect in an ex vivo human lung carcinoma and in vivo simulated lung tumours in a porcine model. High-intensity focused ultrasound is a potential new strategy for treating lung cancer.
Collapse
Affiliation(s)
| | | | | | | | - Thomas Günther Lesser
- Department of Thoracic and Vascular Surgery, SRH Wald-Klinikum Gera, Teaching Hospital of Friedrich-Schiller-University of Jena, Strasse des Friedens 122, D-07548 Gera, Germany.
| |
Collapse
|
49
|
Bischoff S, Arends J, Dörje F, Engeser P, Hanke G, Köchling K, Leischker A, Mühlebach S, Schneider A, Seipt C, Volkert D, Zech U, Stanga Z. S3-Leitlinie der Deutschen Gesellschaft für Ernährungsmedizin (DGEM) in Zusammenarbeit mit der GESKES und der AKE. Aktuel Ernahrungsmed 2013. [DOI: 10.1055/s-0033-1349549] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- S. Bischoff
- Universität Hohenheim, Institut für Ernährungsmedizin, Stuttgart, Deutschland
| | - J. Arends
- Albert-Ludwigs-Universität, KTB Klinik für Tumorbiologie, Freiburg, Deutschland
| | - F. Dörje
- Universitätsklinikum Erlangen, Apotheke, Erlangen, Deutschland
| | - P. Engeser
- Universitätsklinikum Heidelberg, Abteilung Allgemeinmedizin und Versorgungsforschung, Heidelberg, Deutschland
| | - G. Hanke
- A'LPHA-PHARMA-SERVICE GmbH, Heilbronn, Deutschland
| | - K. Köchling
- Universität Hohenheim, Institut für Ernährungsmedizin, Stuttgart, Deutschland
| | - A. Leischker
- Alexianer Krefeld GmbH, Klinik für Allgemeine Innere Medizin und Altersmedizin, Krefeld, Deutschland
| | - S. Mühlebach
- Pharmazentrum, Universität Basel, Department Pharmazeutische Wissenschaften c/o Pharmakoepidemiologie & Spitalpharmazie, Basel, Schweiz
| | - A. Schneider
- Medizinische Hochschule Hannover, Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Hannover, Deutschland
| | - C. Seipt
- Medizinische Hochschule Hannover, Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Hannover, Deutschland
| | - D. Volkert
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Institut für Biomedizin des Alterns, Nürnberg, Deutschland
| | - U. Zech
- Universitätsklinikum Heidelberg, Innere Medizin I und Klinische Chemie, Heidelberg, Deutschland
| | - Z. Stanga
- Universitätsspital Bern, Inselspital, Universitätspoliklinik für Endokrinologie, Diabetologie und Klinische Ernährung, Bern, Schweiz
| | | |
Collapse
|
50
|
Prochnau D, Romeike BF, Bischoff S, Schubert H, Figulla HR, Surber R. Reduction of neurofilaments following renal denervation with radiofrequency current in a sheep model. Int J Cardiol 2013; 168:4450-2. [DOI: 10.1016/j.ijcard.2013.06.149] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 06/30/2013] [Indexed: 11/24/2022]
|