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Ruchay Z, Pape J, Cordt JS, Kerres C, Siehl S, Jansone K, Ackermann J, Veronika G, Liselotte M, Allahqoli L, Maass N, Frauke N, Alkatout I. Does an aptitude for surgery exist and can we predict it? an experimental study. Int J Surg 2024:01279778-990000000-01446. [PMID: 38729125 DOI: 10.1097/js9.0000000000001577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 04/25/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND The selection and allocation of surgeons with a greater potential for high surgical performance are essential aspects of improving the quality, safety and effectiveness of surgical procedures. Objective of this trial was to determine the existence of basic skills and traits that would predict better performance in surgery, and those predictive factors that constitute a driving force in different stages of training. MATERIALS AND METHODS The randomized crossover training trial took place from January 2021 to December 2021 and was conducted at an educational training center for minimally invasive surgery. A total of n=87 physicians (residents and experts) from surgical disciplines and n=239 fifth-year medical students were studied. The participants underwent extensive neuropsychological testing and surgical training, which was performed with conventional as well as robot-assisted laparoscopy by way of identical brief tasks conducted six times in a randomized crossover setting. Main Outcome was the latent factor structure of "psychomotor skills", "personality" and "motivation" based on structural equation modeling. RESULTS The training performance of both students and physicians was significantly explained by the interaction of the three factors (explained variance: 8.2% for students, 23.8% for physicians). In students, motivation (explained variance 8.4%) and personality (explained variance 4.5%) revealed the highest contribution to surgical training performance (explained variance through psychomotor skills 1.1%). In physicians, psychomotor skills (explained variance 27.4%) made the greatest contribution to surgical training performance (explained variance through motivation 2.3%; explained variance through personality 10.5%). CONCLUSION The study showed that surgical performance is sensitive to, and fragile in regard of non-surgery-related general individual traits. This aligns with the notion that early selection of surgeons with prospects of high surgical performance is possible, and perhaps even necessary in order to keep up with future demands on the medical system.
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Affiliation(s)
- Zino Ruchay
- Clinic for Gynecology and Obstetrics, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Julian Pape
- Clinic for Gynecology and Obstetrics, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Julia-Sophie Cordt
- Clinic for Gynecology and Obstetrics, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Carolina Kerres
- Clinic for Gynecology and Obstetrics, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Sebastian Siehl
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Karina Jansone
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Johannes Ackermann
- Clinic for Gynecology and Obstetrics, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Guenther Veronika
- Clinic for Gynecology and Obstetrics, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Mettler Liselotte
- Clinic for Gynecology and Obstetrics, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | | | - Nicolai Maass
- Clinic for Gynecology and Obstetrics, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Nees Frauke
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Ibrahim Alkatout
- Clinic for Gynecology and Obstetrics, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
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Ackermann J, Pape J, Vogler F, Pahls J, Baumann J, Holthaus B, Noé GK, Anapolski M, Ruchay Z, Westermann A, Günther V, Andresen K, Allahqoli L, Moawad G, Neymeyer J, Brügge S, Maass N, Mettler L, Alkatout I. The Feasibility of Practical Training in Minimally Invasive Surgery at Medical School-A Prospective Study on the Pelvitrainer. Medicina (Kaunas) 2024; 60:159. [PMID: 38256419 PMCID: PMC10819215 DOI: 10.3390/medicina60010159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/21/2023] [Accepted: 01/12/2024] [Indexed: 01/24/2024]
Abstract
Background and Objectives: The acquisition of practical skills at medical school is an important part of the multidimensional education program of future physicians. However, medical schools throughout the world have been slow in incorporating practical skills in their curriculum. Therefore, the aims of the present prospective study were (a) to demonstrate the feasibility of such surgical training, (b) to objectify its benefit in medical education, and (c) to investigate the impact of such training on subsequent career choices. Material and Methods: We introduced a two-day laparoscopy course on the pelvitrainer as part of the curriculum of the gynecological internship of fifth year medical students from 2019 to 2020. The results of the students' training were matched to those of surgeons who completed the same curriculum in a professional postgraduate laparoscopy course from 2017 to 2020 in a comparative study design. Additionally, we performed a questionnaire-based evaluation of the impact of the course on medical education and subsequent career choices directly before and after completing the course. Results: A total of 261 medical students and 206 physicians completed the training program. At baseline, the students performed significantly more poorly than physicians in a median of three of four exercises (p < 0.001). However, this evened out in the final runs, during which students performed more poorly than physicians only in one exercise and even better than physicians in one. The general integration of surgical training in medical school curricula was rated very low (12.4% on the VAS, IQR 3-16%) despite the high demand for such training. In the survey, the course was deemed very beneficial for medical education (median VAS 80.7%, IQR 73-98%), but did not appear to influence the students' subsequent career preferences. Conclusions: The acquisition of practical surgical skills during medical school is significantly under-represented in many medical faculties. The benefits of such training, as demonstrated in our study, would improve the education of future physicians.
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Affiliation(s)
- Johannes Ackermann
- Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105 Kiel, Germany; (J.P.); (F.V.); (J.P.); (J.B.); (A.W.); (V.G.); (K.A.); (S.B.); (N.M.); (L.M.)
| | - Julian Pape
- Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105 Kiel, Germany; (J.P.); (F.V.); (J.P.); (J.B.); (A.W.); (V.G.); (K.A.); (S.B.); (N.M.); (L.M.)
| | - Felix Vogler
- Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105 Kiel, Germany; (J.P.); (F.V.); (J.P.); (J.B.); (A.W.); (V.G.); (K.A.); (S.B.); (N.M.); (L.M.)
| | - Julia Pahls
- Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105 Kiel, Germany; (J.P.); (F.V.); (J.P.); (J.B.); (A.W.); (V.G.); (K.A.); (S.B.); (N.M.); (L.M.)
| | - Jorun Baumann
- Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105 Kiel, Germany; (J.P.); (F.V.); (J.P.); (J.B.); (A.W.); (V.G.); (K.A.); (S.B.); (N.M.); (L.M.)
| | - Bernd Holthaus
- Clinic of Obstetrics and Gynecology, St. Elisabeth Hospital, 49401 Damme, Germany;
| | - Günter Karl Noé
- Department of Obstetrics and Gynecology, University Witten/Herdecke, Rheinland Klinikum Dormagen, Dr.-Geldmacher-Straße 20, 41540 Dormagen, Germany; (G.K.N.)
| | - Michael Anapolski
- Department of Obstetrics and Gynecology, University Witten/Herdecke, Rheinland Klinikum Dormagen, Dr.-Geldmacher-Straße 20, 41540 Dormagen, Germany; (G.K.N.)
| | - Zino Ruchay
- Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105 Kiel, Germany; (J.P.); (F.V.); (J.P.); (J.B.); (A.W.); (V.G.); (K.A.); (S.B.); (N.M.); (L.M.)
| | - Anna Westermann
- Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105 Kiel, Germany; (J.P.); (F.V.); (J.P.); (J.B.); (A.W.); (V.G.); (K.A.); (S.B.); (N.M.); (L.M.)
| | - Veronika Günther
- Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105 Kiel, Germany; (J.P.); (F.V.); (J.P.); (J.B.); (A.W.); (V.G.); (K.A.); (S.B.); (N.M.); (L.M.)
| | - Kristin Andresen
- Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105 Kiel, Germany; (J.P.); (F.V.); (J.P.); (J.B.); (A.W.); (V.G.); (K.A.); (S.B.); (N.M.); (L.M.)
| | - Leila Allahqoli
- Midwifery Department, Ministry of Health and Medical Education, Tehran 1467664961, Iran;
| | - Gaby Moawad
- Department of Obstetrics and Gynaecology, The George Washington University Hospital, Washington, DC 20037, USA;
| | - Jörg Neymeyer
- Clinic of Urology, Charité—Universitätsmedizin Berlin, Hindenburgdamm 30, 12200 Berlin, Germany;
| | - Sandra Brügge
- Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105 Kiel, Germany; (J.P.); (F.V.); (J.P.); (J.B.); (A.W.); (V.G.); (K.A.); (S.B.); (N.M.); (L.M.)
| | - Nicolai Maass
- Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105 Kiel, Germany; (J.P.); (F.V.); (J.P.); (J.B.); (A.W.); (V.G.); (K.A.); (S.B.); (N.M.); (L.M.)
| | - Liselotte Mettler
- Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105 Kiel, Germany; (J.P.); (F.V.); (J.P.); (J.B.); (A.W.); (V.G.); (K.A.); (S.B.); (N.M.); (L.M.)
| | - Ibrahim Alkatout
- Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105 Kiel, Germany; (J.P.); (F.V.); (J.P.); (J.B.); (A.W.); (V.G.); (K.A.); (S.B.); (N.M.); (L.M.)
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Günther V, Allahqoli L, Deenadayal-Mettler A, Maass N, Mettler L, Gitas G, Andresen K, Schubert M, Ackermann J, von Otte S, Alkatout I. Molecular Determinants of Uterine Receptivity: Comparison of Successful Implantation, Recurrent Miscarriage, and Recurrent Implantation Failure. Int J Mol Sci 2023; 24:17616. [PMID: 38139443 PMCID: PMC10743587 DOI: 10.3390/ijms242417616] [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: 11/01/2023] [Revised: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
Embryo implantation is one of the most remarkable phenomena in human reproduction and is not yet fully understood. Proper endometrial function as well as a dynamic interaction between the endometrium itself and the blastocyst-the so-called embryo-maternal dialog-are necessary for successful implantation. Several physiological and molecular processes are involved in the success of implantation. This review describes estrogen, progesterone and their receptors, as well as the role of the cytokines interleukin (IL)-6, IL-8, leukemia inhibitory factor (LIF), IL-11, IL-1, and the glycoprotein glycodelin in successful implantation, in cases of recurrent implantation failure (RIF) and in cases of recurrent pregnancy loss (RPL). Are there differences at the molecular level underlying RIF or RPL? Since implantation has already taken place in the case of RPL, it is conceivable that different molecular biological baseline situations underlie the respective problems.
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Affiliation(s)
- Veronika Günther
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 3 (House C), 24105 Kiel, Germany; (V.G.)
- University Fertility Center, Ambulanzzentrum of University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 3 (House C), 24105 Kiel, Germany
| | - Leila Allahqoli
- School of Public Health, Iran University of Medical Sciences (IUMS), Tehran 14535, Iran
| | - Anupama Deenadayal-Mettler
- University Fertility Center, Ambulanzzentrum of University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 3 (House C), 24105 Kiel, Germany
| | - Nicolai Maass
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 3 (House C), 24105 Kiel, Germany; (V.G.)
| | - Liselotte Mettler
- University Fertility Center, Ambulanzzentrum of University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 3 (House C), 24105 Kiel, Germany
| | - Georgios Gitas
- Private Gynecologic Practice, Chrisostomou Smirnis 11Β, 54622 Thessaloniki, Greece
| | - Kristin Andresen
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 3 (House C), 24105 Kiel, Germany; (V.G.)
| | - Melanie Schubert
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 3 (House C), 24105 Kiel, Germany; (V.G.)
| | - Johannes Ackermann
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 3 (House C), 24105 Kiel, Germany; (V.G.)
| | - Sören von Otte
- University Fertility Center, Ambulanzzentrum of University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 3 (House C), 24105 Kiel, Germany
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 3 (House C), 24105 Kiel, Germany; (V.G.)
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Ackermann J, Baumann J, Pape J, Pahls J, Ruchay Z, Spüntrup C, Holthaus B, Noé G, Anapolski M, Meinhold-Heerlein I, Peters G, Willer D, Westermann A, Brügge S, Günther V, Maass N, Mettler L, Alkatout I. Factors influencing surgical performance and learning progress in minimally invasive surgery - results of an interdisciplinary multicenter study. Int J Surg 2023; 109:2975-2986. [PMID: 37462985 PMCID: PMC10583955 DOI: 10.1097/js9.0000000000000590] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 04/05/2023] [Accepted: 06/26/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Advancing surgical techniques require a high level of adaptation and learning skills on the part of surgeons. The authors need selection procedures and decision support systems for the recruitment of medical students and young surgeons. The authors aimed to investigate factors influencing the surgical performance and learning abilities of surgeons and medical students. MATERIALS AND METHODS The training scores of persons attending 16 standardized training courses (at three training centers) of the German Working Group for Gynecological Endoscopy (AGE e.V.) from 2017 to 2020, individual characteristics, and the results of psychomotor tests of three-dimensional imagination and hand-eye coordination were correlated. Similar analyses were performed for medical students in their final clinical year from 2019 to 2020. The training concept was evaluated in a prospective, multicenter, interdisciplinary, multinational setting. RESULTS In all, 180 of 206 physicians (response rate 87.4%) and 261 medical students (response rate 100%) completed the multistage training concept successfully. Of personal characteristics, the strongest correlation was noted for good surgical performance and learning success, and the absolute number of performed laparoscopic surgeries ( r =0.28-0.45, P <0.001/ r =0.1-0.28, P <0.05). A high score on the spatial visualization ability test was also correlated with good surgical performance ( r =0.18-0.27, P <0.01). Among medical students with no surgical experience, however, age was negatively correlated with surgical performance, that is the higher the age, the lower the surgical performance ( r =0.13/ r =0.22, P <0.05/ P <0.001). CONCLUSION Individual factors (e.g. surgical experience, self-assessment, spatial visualization ability, eye-hand coordination, age) influence surgical performance and learning. Further research will be needed to create better decision support systems and selection procedures for prospective physicians. The possibilities of surgical training should be improved, promoted, and made accessible to a maximum number of surgical trainees because individual learning curves can be overcome even by less talented surgeons. Training options should be institutionalized for those attending medical school.
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Affiliation(s)
- Johannes Ackermann
- Kiel School of Gynaecological Endoscopy, Department of Gynaecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel
| | - Jorun Baumann
- Kiel School of Gynaecological Endoscopy, Department of Gynaecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel
| | - Julian Pape
- Kiel School of Gynaecological Endoscopy, Department of Gynaecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel
| | - Julia Pahls
- Kiel School of Gynaecological Endoscopy, Department of Gynaecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel
| | - Zino Ruchay
- Kiel School of Gynaecological Endoscopy, Department of Gynaecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel
| | | | - Bernd Holthaus
- Clinic of Obstetrics and Gynecology, St. Elisabeth Hospital, Damme
| | - Günter Noé
- Department of Obstetrics and Gynecology, University Witten/Herdecke, Rheinland Klinikum Dormagen, Dormagen
| | - Michael Anapolski
- Department of Obstetrics and Gynecology, University Witten/Herdecke, Rheinland Klinikum Dormagen, Dormagen
| | - Ivo Meinhold-Heerlein
- Department of Gynecology and Obstetrics, University Hospital of Giessen, Giessen, Germany
| | - Göntje Peters
- Kiel School of Gynaecological Endoscopy, Department of Gynaecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel
| | - Damaris Willer
- Kiel School of Gynaecological Endoscopy, Department of Gynaecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel
| | - Anna Westermann
- Kiel School of Gynaecological Endoscopy, Department of Gynaecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel
| | - Sandra Brügge
- Kiel School of Gynaecological Endoscopy, Department of Gynaecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel
| | - Veronika Günther
- Kiel School of Gynaecological Endoscopy, Department of Gynaecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel
| | - Nicolai Maass
- Kiel School of Gynaecological Endoscopy, Department of Gynaecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel
| | - Liselotte Mettler
- Kiel School of Gynaecological Endoscopy, Department of Gynaecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel
| | - Ibrahim Alkatout
- Kiel School of Gynaecological Endoscopy, Department of Gynaecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel
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Allahqoli L, Mazidimoradi A, Momenimovahed Z, Günther V, Ackermann J, Salehiniya H, Alkatout I. Appendiceal Endometriosis: A Comprehensive Review of the Literature. Diagnostics (Basel) 2023; 13:diagnostics13111827. [PMID: 37296678 DOI: 10.3390/diagnostics13111827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 06/12/2023] Open
Abstract
Objective: the purpose of this review was to evaluate the prevalence of appendiceal endometriosis and the safety of concomitant appendectomy in women with endometriosis or pelvic pain. Materials and Methods: We searched the electronic databases Medline (PubMed), Scopus, Embase, and Web of Science (WOS). The search was not subject to any limitation in terms of time or method. The primary research question was: what is the prevalence of appendiceal endometriosis? The secondary research question was: is it safe to perform appendectomy during surgery for endometriosis? Publications that reported data about appendiceal endometriosis or appendectomy in women with endometriosis were reviewed regarding the inclusion criteria. Results: We found 1418 records. After review and screening, we included 75 studies published between 1975 and 2021. With regard to the first question of the review, we found 65 eligible studies and divided these into the following two categories: (a) endometriosis of the appendix presenting as acute appendicitis, and (b) endometriosis of the appendix as an incidental finding in gynecological surgery. Forty-four case reports described appendiceal endometriosis in women who were admitted for the treatment of pain in the right-sided lower abdomen. Endometriosis of the appendix was observed in 2.67% (range, 0.36-23%) of women who were admitted due to acute appendicitis. In addition, appendiceal endometriosis was an incidental finding during gynecological surgery in 7.23% of cases (range, 1-44.3%). With regard to the second question of the review, which was the safety of appendectomy in women with endometriosis or pelvic pain, we found 11 eligible studies. Reviewed cases had no significant intraoperative or follow-up complications during the 12 weeks. Conclusion: Based on the reviewed studies, coincidental appendectomy appears reasonably safe and was associated with no complications in the cases reviewed for the present report.
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Affiliation(s)
- Leila Allahqoli
- Ministry of Health and Medical Education, Tehran 1467664961, Iran
| | - Afrooz Mazidimoradi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz 7134814336, Iran
| | - Zohre Momenimovahed
- Department of Midwifery and Reproductive Health, Qom University of Medical Sciences, Qom 3716993456, Iran
| | - Veronika Günther
- University Hospitals Schleswig-Holstein, Kiel School of Gynaecological Endoscopy, Campus Kiel, Arnold-Heller-Str. 3, Haus 24, 24105 Kiel, Germany
| | - Johannes Ackermann
- University Hospitals Schleswig-Holstein, Kiel School of Gynaecological Endoscopy, Campus Kiel, Arnold-Heller-Str. 3, Haus 24, 24105 Kiel, Germany
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand 9717853577, Iran
| | - Ibrahim Alkatout
- University Hospitals Schleswig-Holstein, Kiel School of Gynaecological Endoscopy, Campus Kiel, Arnold-Heller-Str. 3, Haus 24, 24105 Kiel, Germany
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Mahmoudi S, Bernatz S, Ackermann J, Koch V, Dos Santos DP, Grünewald LD, Yel I, Martin SS, Scholtz JE, Stehle A, Walter D, Zeuzem S, Wild PJ, Vogl TJ, Kinzler MN. Computed Tomography Radiomics to Differentiate Intrahepatic Cholangiocarcinoma and Hepatocellular Carcinoma. Clin Oncol (R Coll Radiol) 2023; 35:e312-e318. [PMID: 36804153 DOI: 10.1016/j.clon.2023.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/05/2022] [Accepted: 01/25/2023] [Indexed: 02/04/2023]
Abstract
AIMS Intrahepatic cholangiocarcinoma (iCCA) and hepatocellular carcinoma (HCC) differ in prognosis and treatment. We aimed to non-invasively differentiate iCCA and HCC by means of radiomics extracted from contrast-enhanced standard-of-care computed tomography (CT). MATERIALS AND METHODS In total, 94 patients (male, n = 68, mean age 63.3 ± 12.4 years) with histologically confirmed iCCA (n = 47) or HCC (n = 47) who underwent contrast-enhanced abdominal CT between August 2014 and November 2021 were retrospectively included. The enhancing tumour border was manually segmented in a clinically feasible way by defining three three-dimensional volumes of interest per tumour. Radiomics features were extracted. Intraclass correlation analysis and Pearson metrics were used to stratify robust and non-redundant features with further feature reduction by LASSO (least absolute shrinkage and selection operator). Independent training and testing datasets were used to build four different machine learning models. Performance metrics and feature importance values were computed to increase the models' interpretability. RESULTS The patient population was split into 65 patients for training (iCCA, n = 32) and 29 patients for testing (iCCA, n = 15). A final combined feature set of three radiomics features and the clinical features age and sex revealed a top test model performance of receiver operating characteristic (ROC) area under the curve (AUC) = 0.82 (95% confidence interval =0.66-0.98; train ROC AUC = 0.82) using a logistic regression classifier. The model was well calibrated, and the Youden J Index suggested an optimal cut-off of 0.501 to discriminate between iCCA and HCC with a sensitivity of 0.733 and a specificity of 0.857. CONCLUSIONS Radiomics-based imaging biomarkers can potentially help to non-invasively discriminate between iCCA and HCC.
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Affiliation(s)
- S Mahmoudi
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany.
| | - S Bernatz
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany; Dr. Senckenberg Institute for Pathology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany; University Cancer Center Frankfurt (UCT), University Hospital, Goethe University, Frankfurt am Main, Germany
| | - J Ackermann
- Department of Molecular Bioinformatics, Institute of Computer Science, Goethe University, Frankfurt am Main, Germany
| | - V Koch
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - D P Dos Santos
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany; Department of Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany
| | - L D Grünewald
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - I Yel
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - S S Martin
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - J-E Scholtz
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - A Stehle
- Department of Internal Medicine I, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - D Walter
- Department of Internal Medicine I, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - S Zeuzem
- Department of Internal Medicine I, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - P J Wild
- Dr. Senckenberg Institute for Pathology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt am Main, Germany; Frankfurt Institute for Advanced Studies (FIAS), Frankfurt am Main, Germany
| | - T J Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - M N Kinzler
- Department of Internal Medicine I, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
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7
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Gitas G, Pados G, Laganà AS, Guenther V, Ackermann J, Alkatout I. Role of laparoscopic hysterectomy in cervical and endometrial cancer: a narrative review. MINIM INVASIV THER 2023; 32:1-11. [PMID: 36512487 DOI: 10.1080/13645706.2022.2154166] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 12/15/2022]
Abstract
Endometrial cancer is the most common carcinoma of the female genital organs and cervical cancer is the leading cause of cancer death in women worldwide. The aim of this review is to evaluate the role of laparoscopic hysterectomy in patients with endometrial and cervical cancer in this period, and analyze the outcome of hysterectomy in terms of survival. Moreover, we present the historical background, new techniques, the anatomical features, and surgical steps of radical hysterectomy. According to new evidence, minimally invasive surgery in patients with cervical cancer is associated with higher rates of recurrence and mortality compared to the open approach. Despite the numerous explanations offered for this phenomenon, the reasons for these results are unclear. Additional large trials have been launched to reevaluate the above-mentioned data. On contrary, the laparoscopic approach provides surgical outcomes and similar survival rates as open surgery in patients with early endometrial carcinoma. Furthermore, the radicality of hysterectomy does not influence local recurrence rates or overall survival in cases with complete surgical removal of the tumor. A laparoscopic radical hysterectomy is no longer an option in patients with cervical cancer. When minimally invasive surgery is offered, the patients must be counseled in detail about the current debate.
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Affiliation(s)
- Georgios Gitas
- Department of Gynecology, Breast Center, Charité University Hospital, Berlin, Germany
| | - George Pados
- First Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, Filippo Del Ponte Hospital, University of Insubria, Varese, Italy
| | - Veronika Guenther
- Department of Obstetrics and Gynecology, University Hospital of Schleswig Holstein, Kiel, Germany
| | - Johannes Ackermann
- Department of Obstetrics and Gynecology, University Hospital of Schleswig Holstein, Kiel, Germany
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, Filippo Del Ponte Hospital, University of Insubria, Varese, Italy
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8
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Günther V, Allahqoli L, Gitas G, Maass N, Tesch K, Ackermann J, Rosam P, Mettler L, von Otte S, Alkatout I. Impact of Adenomyosis on Infertile Patients-Therapy Options and Reproductive Outcomes. Biomedicines 2022; 10:biomedicines10123245. [PMID: 36552001 PMCID: PMC9775960 DOI: 10.3390/biomedicines10123245] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/01/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
Adenomyosis is associated with a negative impact on reproductive outcomes. Although adenomyosis is detected more frequently in women of late reproductive age, its impact on pregnancy rates is important because, in today's world, family planning has shifted towards the late reproductive phase of life for many women. Although the diagnostic indications for imaging studies are well-known, we lack strict diagnostic criteria and classification systems concerning the extent of the disease. Selecting the optimal evidence-based treatment option for adenomyosis is difficult because of the paucity of evidence concerning the association between fertility and the degree and composition of adenomyosis. Furthermore, the treatment of infertility might interfere with the treatment of adenomyosis due to the presence of pain. The aim of this review is to analyze the association between adenomyosis and infertility, and describe treatment options to enhance reproductive outcomes. The following aspects will be addressed in detail: (a) prevalence and causes of adenomyosis, (b) diagnostic tools with imaging techniques, (c) clinical symptoms, (d) proposed pathomechanism of adenomyosis and infertility, and (e) different treatment approaches (pharmacological, surgical, others) and their impact on reproductive outcomes.
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Affiliation(s)
- Veronika Günther
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 3 (House C), 24105 Kiel, Germany
- University Fertility Center, Ambulanzzentrum des UKSH gGmbH, Arnold-Heller-Strasse 3 (House C), 24105 Kiel, Germany
| | - Leila Allahqoli
- School of Public Health, Iran University of Medical Sciences (IUMS), Tehran 14167-53955, Iran
| | - Georgios Gitas
- Private Gynecologic Practice, Chrisostomou Smirnis 11Β, 54622 Thessaloniki, Greece
| | - Nicolai Maass
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 3 (House C), 24105 Kiel, Germany
| | - Karolin Tesch
- Department of Radiology and Neuroradiology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 3 (House C), 24105 Kiel, Germany
| | - Johannes Ackermann
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 3 (House C), 24105 Kiel, Germany
| | - Paula Rosam
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 3 (House C), 24105 Kiel, Germany
| | - Liselotte Mettler
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 3 (House C), 24105 Kiel, Germany
| | - Sören von Otte
- University Fertility Center, Ambulanzzentrum des UKSH gGmbH, Arnold-Heller-Strasse 3 (House C), 24105 Kiel, Germany
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 3 (House C), 24105 Kiel, Germany
- Correspondence:
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9
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Clément P, Ackermann J, Sahin-Solmaz N, Herbertz S, Boero G, Kruss S, Brugger J. Comparison of electrical and optical transduction modes of DNA-wrapped SWCNT nanosensors for the reversible detection of neurotransmitters. Biosens Bioelectron 2022; 216:114642. [DOI: 10.1016/j.bios.2022.114642] [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: 06/08/2022] [Revised: 08/05/2022] [Accepted: 08/15/2022] [Indexed: 11/02/2022]
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Olivares-Postigo D, Gorrini F, Bitonto V, Ackermann J, Giri R, Krueger A, Bifone A. Divergent Effects of Laser Irradiation on Ensembles of Nitrogen-Vacancy Centers in Bulk and Nanodiamonds: Implications for Biosensing. Nanoscale Res Lett 2022; 17:95. [PMID: 36161373 PMCID: PMC9512947 DOI: 10.1186/s11671-022-03723-2] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 08/22/2022] [Indexed: 06/16/2023]
Abstract
Ensembles of negatively charged nitrogen-vacancy centers (NV-) in diamond have been proposed for sensing of magnetic fields and paramagnetic agents, and as a source of spin-order for the hyperpolarization of nuclei in magnetic resonance applications. To this end, strongly fluorescent nanodiamonds (NDs) represent promising materials, with large surface areas and dense ensembles of NV-. However, surface effects tend to favor the less useful neutral form, the NV0 centers, and strategies to increase the density of shallow NV- centers have been proposed, including irradiation with strong laser power (Gorrini in ACS Appl Mater Interfaces. 13:43221-43232, 2021). Here, we study the fluorescence properties and optically detected magnetic resonance (ODMR) of NV- centers as a function of laser power in strongly fluorescent bulk diamond and in nanodiamonds obtained by nanomilling of the native material. In bulk diamond, we find that increasing laser power increases ODMR contrast, consistent with a power-dependent increase in spin-polarization. Conversely, in nanodiamonds we observe a non-monotonic behavior, with a decrease in ODMR contrast at higher laser power. We hypothesize that this phenomenon may be ascribed to more efficient NV-→NV0 photoconversion in nanodiamonds compared to bulk diamond, resulting in depletion of the NV- pool. A similar behavior is shown for NDs internalized in macrophage cells under the typical experimental conditions of imaging bioassays. Our results suggest strong laser irradiation is not an effective strategy in NDs, where the interplay between surface effects and local microenvironment determine the optimal experimental conditions.
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Affiliation(s)
- Domingo Olivares-Postigo
- Center for Neuroscience and Cognitive Systems, Istituto Italiano Di Tecnologia, Corso Bettini 31, 38068, Rovereto, Trento, Italy.
- Molecular Biology Center, University of Torino, via Nizza 52, 10126, Turin, Italy.
- Department of Molecular Biotechnology and Health Sciences, University of Torino, via Nizza 52, 10126, Turin, Italy.
| | - Federico Gorrini
- Molecular Biology Center, University of Torino, via Nizza 52, 10126, Turin, Italy
- Center for Sustainable Future Technologies, Istituto Italiano Di Tecnologia, via Livorno 60, 10144, Turin, Italy
| | - Valeria Bitonto
- Department of Molecular Biotechnology and Health Sciences, University of Torino, via Nizza 52, 10126, Turin, Italy
| | - Johannes Ackermann
- Institut Für Organische Chemie, Julius-Maximilians-Universität Würzburg, Am Hubland, 97074, Würzburg, Germany
| | - Rakshyakar Giri
- Center for Neuroscience and Cognitive Systems, Istituto Italiano Di Tecnologia, Corso Bettini 31, 38068, Rovereto, Trento, Italy
| | - Anke Krueger
- Institut Für Organische Chemie, Julius-Maximilians-Universität Würzburg, Am Hubland, 97074, Würzburg, Germany
- Wilhelm Conrad Röntgen Center for Complex Materials Research (RCCM), Julius-Maximilians University Würzburg, 97074, Würzburg, Germany
| | - Angelo Bifone
- Molecular Biology Center, University of Torino, via Nizza 52, 10126, Turin, Italy.
- Department of Molecular Biotechnology and Health Sciences, University of Torino, via Nizza 52, 10126, Turin, Italy.
- Center for Sustainable Future Technologies, Istituto Italiano Di Tecnologia, via Livorno 60, 10144, Turin, Italy.
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Gitas G, Hanker L, Rody A, Ackermann J, Alkatout I. Robotic surgery in gynecology: is the future already here? MINIM INVASIV THER 2022; 31:815-824. [DOI: 10.1080/13645706.2021.2010763] [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: 10/19/2022]
Affiliation(s)
- Georgios Gitas
- Department of Obstetrics and Gynecology, University Hospital of Schleswig Holstein, Luebeck, Germany
| | - Lars Hanker
- Department of Obstetrics and Gynecology, University Hospital of Schleswig Holstein, Luebeck, Germany
| | - Achim Rody
- Department of Obstetrics and Gynecology, University Hospital of Schleswig Holstein, Luebeck, Germany
| | - Johannes Ackermann
- Department of Obstetrics and Gynecology, University Hospital of Schleswig Holstein, Kiel, Germany
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, University Hospital of Schleswig Holstein, Kiel, Germany
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Ackermann J, Pahls J, Baumann J, Spüntrup C, Holthaus B, Noé G, Anapolski M, Meinhold-Heerlein I, Laganà AS, Peters G, Pape J, Willer D, Westermann AM, Günther V, Maass N, Mettler L, Alkatout I. The pelvitrainer for training in laparoscopic surgery – A prospective, multicenter, interdisciplinary study: Experimental research. Int J Surg 2022; 101:106604. [DOI: 10.1016/j.ijsu.2022.106604] [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: 02/08/2022] [Accepted: 03/29/2022] [Indexed: 11/28/2022]
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13
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Günther V, Dasari-Mettler A, Mettler L, Otte SV, Ackermann J, Maass N, Alkatout I. Is Blastocyst Culture Responsible for Higher Pregnancy Rates? A Critical Analysis of the Day of Optimal Embryo Transfer and Embryo Quality. JBRA Assist Reprod 2022; 26:492-499. [PMID: 35403418 PMCID: PMC9355446 DOI: 10.5935/1518-0557.20210098] [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] [Indexed: 11/24/2022] Open
Abstract
Objective A prolonged culture of embryos beyond day 2-3 to day 5 (blastocyst culture) after fertilization might be an alternative, simple way of selecting suitable embryos for transfer. Extending embryo culture to day 5/6 is a selection tool to choose an embryo with a greater likelihood of implantation rather than improve embryo quality. Methods This retrospective study analyzed 1126 fresh IVF/ICSI cycles performed between February 1, 2014 and December 30, 2018 at the University Fertility Center in Kiel, Germany, to determine the impact of blastocyst culture on pregnancy rates and the association between embryo quality and pregnancy rates. Results Clinical pregnancy was achieved in 154 cases (19.5%) after day 2/3 transfer and in 76 cases (22.7%) after day 5 transfer. Pearson’s two-sided chi-squared test yielded no statistical significance (p=0.221). The analysis of clinical pregnancy rates in relation to the quality of transferred embryos yielded the following results: 49 (10.7%) pregnancies in cases of no ideal embryo(s); 122 (27.2%) in cases of at least one ideal embryo; and 59 (26.7%) for both quality groups. Pearson’s two-sided Chi-squared test was statistically significant (p<0.001). Conclusions Our data revealed no improvement of pregnancy rates after blastocyst transfer compared with day 2/3 transfers. However, we noted higher pregnancy rates when an embryo of good quality was transferred.
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Affiliation(s)
- Veronika Günther
- Clinic for Obstetrics and Gynecology 24105 Kiel Clinic for Obstetrics and Gynecology, UKSH Campus Kiel, Arnold-Heller-Straße 3 (Haus C), 24105 Kiel, Germany.,University Fertility Center Ambulanzzentrum des UKSH gGmbH 24105 Kiel Germany University Fertility Center, Ambulanzzentrum des UKSH gGmbH, Arnold-Heller-Straße 3 (Haus C), 24105 Kiel, Germany
| | - Anupama Dasari-Mettler
- University Fertility Center Ambulanzzentrum des UKSH gGmbH 24105 Kiel Germany University Fertility Center, Ambulanzzentrum des UKSH gGmbH, Arnold-Heller-Straße 3 (Haus C), 24105 Kiel, Germany
| | - Liselotte Mettler
- Clinic for Obstetrics and Gynecology 24105 Kiel Clinic for Obstetrics and Gynecology, UKSH Campus Kiel, Arnold-Heller-Straße 3 (Haus C), 24105 Kiel, Germany
| | - Sören von Otte
- University Fertility Center Ambulanzzentrum des UKSH gGmbH 24105 Kiel Germany University Fertility Center, Ambulanzzentrum des UKSH gGmbH, Arnold-Heller-Straße 3 (Haus C), 24105 Kiel, Germany
| | - Johannes Ackermann
- Clinic for Obstetrics and Gynecology 24105 Kiel Clinic for Obstetrics and Gynecology, UKSH Campus Kiel, Arnold-Heller-Straße 3 (Haus C), 24105 Kiel, Germany
| | - Nicolai Maass
- Clinic for Obstetrics and Gynecology 24105 Kiel Clinic for Obstetrics and Gynecology, UKSH Campus Kiel, Arnold-Heller-Straße 3 (Haus C), 24105 Kiel, Germany
| | - Ibrahim Alkatout
- Clinic for Obstetrics and Gynecology 24105 Kiel Clinic for Obstetrics and Gynecology, UKSH Campus Kiel, Arnold-Heller-Straße 3 (Haus C), 24105 Kiel, Germany
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14
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Alkatout I, Holthaus B, Bozzaro C, Wedel T, Westermann AM, Westermann M, Mettler L, Jünemann KP, Becker T, Maass N, Ackermann J. Surgeon and surgical conference attendee views on live surgery events. Br J Surg 2021; 108:e371-e372. [PMID: 34476469 DOI: 10.1093/bjs/znab297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 07/25/2021] [Indexed: 12/21/2022]
Abstract
Based on the principles of biomedical ethics, the authors conducted a survey focusing on the ethical aspects of, didactic benefits of and possible alternatives to live surgery events. This work provides an investigation of the ethics of live surgery events in an interdisciplinary and multicentre setting. Critical ethical concerns regarding the justification of such events are highlighted through evaluation of attendees and surgeons.
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Affiliation(s)
- I Alkatout
- Department of Obstetrics and Gynaecology, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Kiel, Germany
| | - B Holthaus
- Clinic of Obstetrics and Gynaecology, St. Elisabeth Hospital, Damme, Germany
| | - C Bozzaro
- Medical Ethics, Institute of Experimental Medicine, Christian-Albrechts University Kiel, Kiel, Germany
| | - T Wedel
- Institute of Anatomy, Christian-Albrechts University Kiel, Kiel, Germany
| | - A M Westermann
- Department of Obstetrics and Gynaecology, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Kiel, Germany.,Medical Ethics, Institute of Experimental Medicine, Christian-Albrechts University Kiel, Kiel, Germany
| | - M Westermann
- Department of Anaesthesiology and Surgical Intensive Care Medicine, University Hospitals Schleswig-Holstein, Kiel, Germany
| | - L Mettler
- Department of Obstetrics and Gynaecology, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Kiel, Germany
| | - K-P Jünemann
- Department of Urology and Paediatric Urology, University Hospitals Schleswig-Holstein, Kiel, Germany
| | - T Becker
- Department of General, Visceral, Thoracic, Transplant, and Paediatric Surgery, University Hospitals Schleswig-Holstein, Kiel, Germany
| | - N Maass
- Department of Obstetrics and Gynaecology, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Kiel, Germany
| | - J Ackermann
- Department of Obstetrics and Gynaecology, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Kiel, Germany
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15
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Rejeski K, Perez A, Sesques P, Berger C, Jentzsch L, Mougiakakos D, Frölich L, Ackermann J, Bücklein V, Blumenberg V, Schmidt C, Jallades L, Fehse B, Faul C, Karschnia P, Weigert O, Dreyling M, Hoster E, Locke F, Bergwelt‐Baildon M, Mackensen A, Bethge W, Ayuk F, Bachy E, Salles G, Jain M, Subklewe M. CAR‐HEMATOTOX: A DISCRIMINATIVE MODEL FOR CAR T‐CELL RELATED HEMATOTOXICITY IN RELAPSED/REFRACTORY LARGE B‐CELL LYMPHOMA. Hematol Oncol 2021. [DOI: 10.1002/hon.82_2879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- K. Rejeski
- University Hospital of the LMU Munich Department of Hematology/Oncology Munich Germany
| | - A. Perez
- Moffitt Cancer Center Department of Blood and Marrow Transplant and Cellular Immunotherapy Moffitt Cancer Center, Tampa, USA Tampa USA
| | - P. Sesques
- Hospices Civils de Lyon Institut National de la Santé et de la Recherche Médicale (INSERM) Lyon France
| | - C. Berger
- University Hospital Hamburg‐Eppendorf Department of Hematology, Oncology and Pulmonology Hamburg Germany
| | - L. Jentzsch
- University Hospital Tübingen Department of Hematology, Oncology, Immunology and Rheumatology Tübingen Germany
| | - D. Mougiakakos
- University Hospital of Erlangen Department of Internal Medicine 5, Hematology and Oncology Erlangen Germany
| | - L. Frölich
- University Hospital of the LMU Munich Department of Hematology/Oncology Munich Germany
| | - J. Ackermann
- University Hospital of the LMU Munich Department of Hematology/Oncology Munich Germany
| | - V. Bücklein
- University Hospital of the LMU Munich Department of Hematology/Oncology Munich Germany
| | - V. Blumenberg
- University Hospital of the LMU Munich Department of Hematology/Oncology Munich Germany
| | - C. Schmidt
- University Hospital of the LMU Munich Department of Hematology/Oncology Munich Germany
| | - L. Jallades
- Hospices Civils de Lyon Institut National de la Santé et de la Recherche Médicale (INSERM) Lyon France
| | - B. Fehse
- University Hospital Hamburg‐Eppendorf Department of Hematology, Oncology and Pulmonology Hamburg Germany
| | - C. Faul
- University Hospital Tübingen Department of Hematology, Oncology, Immunology and Rheumatology Tübingen Germany
| | - P. Karschnia
- University Hospital of the LMU Munich Department of Neurosurgery Munich Germany
| | - O. Weigert
- University Hospital of the LMU Munich Department of Hematology/Oncology Munich Germany
| | - M. Dreyling
- University Hospital of the LMU Munich Department of Hematology/Oncology Munich Germany
| | - E. Hoster
- LMU Munich Institute for Medical Informatics Biometry and Epidemiology Munich Germany
| | - F. Locke
- Moffitt Cancer Center Department of Blood and Marrow Transplant and Cellular Immunotherapy Moffitt Cancer Center, Tampa, USA Tampa USA
| | - M. Bergwelt‐Baildon
- University Hospital of the LMU Munich Department of Hematology/Oncology Munich Germany
| | - A. Mackensen
- University Hospital of Erlangen Department of Internal Medicine 5, Hematology and Oncology Erlangen Germany
| | - W. Bethge
- University Hospital Tübingen Department of Hematology, Oncology, Immunology and Rheumatology Tübingen Germany
| | - F. Ayuk
- University Hospital Hamburg‐Eppendorf Department of Hematology, Oncology and Pulmonology Hamburg Germany
| | - E. Bachy
- Hospices Civils de Lyon Institut National de la Santé et de la Recherche Médicale (INSERM) Lyon France
| | - G. Salles
- MSKCC, Lymphoma Service Department of Medicine NYC New York USA
| | - M. Jain
- Moffitt Cancer Center Department of Blood and Marrow Transplant and Cellular Immunotherapy Moffitt Cancer Center, Tampa, USA Tampa USA
| | - M. Subklewe
- University Hospital of the LMU Munich Department of Hematology/Oncology Munich Germany
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Bücklein V, Blumenberg V, Ackermann J, Frölich L, Winkelmann M, Schmidt C, Rejeski K, Ruzicka M, Müller N, von Baumgarten L, Schöberl F, Hildebrandt M, Humpe A, Kunz W, Hoster E, von Bergwelt M, Subklewe M. EXTRANODAL DISEASE IS ASSOCIATED WITH SHORTER PROGRESSION‐FREE SURVIVAL AFTER CD19‐CAR T‐CELL THERAPY FOR RELAPSED/REFRACTORY DIFFUSE LARGE B‐CELL LYMPHOMA. Hematol Oncol 2021. [DOI: 10.1002/hon.183_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- V. Bücklein
- University Hospital LMU Munich Department of Medicine III Munich Germany
| | - V. Blumenberg
- University Hospital LMU Munich Department of Medicine III Munich Germany
| | - J. Ackermann
- University Hospital LMU Munich Department of Medicine III Munich Germany
| | - L. Frölich
- University Hospital LMU Munich Department of Medicine III Munich Germany
| | - M. Winkelmann
- University Hospital LMU Munich Department of Radiology Munich Germany
| | - C. Schmidt
- University Hospital LMU Munich Department of Medicine III Munich Germany
| | - K. Rejeski
- University Hospital LMU Munich Department of Medicine III Munich Germany
| | - M. Ruzicka
- University Hospital LMU Munich Department of Medicine III Munich Germany
| | - N. Müller
- University Hospital LMU Munich Department of Medicine III Munich Germany
| | - L. von Baumgarten
- University Hospital LMU Munich Department of Neurosurgery Munich Germany
| | - F. Schöberl
- University Hospital LMU Munich Department of Neurology Munich Germany
| | - M. Hildebrandt
- University Hospital LMU Munich Department of Transfusion Medicine Munich Germany
| | - A. Humpe
- University Hospital LMU Munich Department of Transfusion Medicine Munich Germany
| | - W. Kunz
- University Hospital LMU Munich Department of Radiology Munich Germany
| | - E. Hoster
- LMU Munich Institute for Medical Information Processing, Biometry, and Epidemiology Munich Germany
| | - M. von Bergwelt
- University Hospital LMU Munich Department of Medicine III Munich Germany
| | - M. Subklewe
- University Hospital LMU Munich Department of Medicine III Munich Germany
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Alkatout I, Günther V, Brügge S, Ackermann J, Krüger M, Bauerschlag D, Maass N, Lippross S, Cascorbi I, Egberts JH, Becker T, Osmonov D, Jünemann KP, Wedel T. Involvement of medical students in a surgery congress: impact on learning motivation, decision-making for a career in surgery, and educational curriculum. Wien Med Wochenschr 2021; 171:182-193. [PMID: 33443613 PMCID: PMC8057979 DOI: 10.1007/s10354-020-00802-w] [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: 09/28/2020] [Accepted: 11/17/2020] [Indexed: 11/28/2022]
Abstract
During the preclinical period of medical school, the clinical relevance of theoretical knowledge is given little attention. Medical students of the second year were invited to participate in an interdisciplinary congress for robot-assisted and digital surgery. The students had to evaluate the impact of the congress on their learning motivation, decision-making for a career in surgery, and relevance for their educational curriculum. Participation in the congress increased their learning motivation for preclinical subjects, and significantly increased their interest in a surgical career. Most students considered active involvement in medical congresses a valuable supplement to the medical curriculum. Congress participation during the preclinical period was ranked positively by medical students. Greater learning motivation and enthusiasm for the pilot teaching project as well as for surgical disciplines were registered. Thus, early involvement of medical students in scientific congresses should be an integral part of their educational curriculum.
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Affiliation(s)
- Ibrahim Alkatout
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, House C, 24105, Kiel, Germany.
| | - Veronika Günther
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, House C, 24105, Kiel, Germany
| | - Sandra Brügge
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, House C, 24105, Kiel, Germany
| | - Johannes Ackermann
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, House C, 24105, Kiel, Germany
| | - Magret Krüger
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, House C, 24105, Kiel, Germany
| | - Dirk Bauerschlag
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, House C, 24105, Kiel, Germany
| | - Nicolai Maass
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, House C, 24105, Kiel, Germany
| | - Sebastian Lippross
- Department of Trauma Surgery and Orthopaedics, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Germany
| | - Ingolf Cascorbi
- Institute of Experimental and Clinical Pharmacology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Germany
| | - Jan-Hendrik Egberts
- Department of General‑, Visceral‑, Thoracic‑, Transplant- and Paediatric Surgery, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Germany
| | - Thomas Becker
- Department of General‑, Visceral‑, Thoracic‑, Transplant- and Paediatric Surgery, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Germany
| | - Daniar Osmonov
- Department of Urology and Pediatric Urology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Germany
| | - Klaus-Peter Jünemann
- Department of Urology and Pediatric Urology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Germany
| | - Thilo Wedel
- Center for Clinical Anatomy, Institute of Anatomy, Christian-Albrechts-Universität zu Kiel, Otto-Hahn-Platz 8, 24118, Kiel, Germany
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Fürnstahl P, Casari FA, Ackermann J, Marcon M, Leunig M, Ganz R. Computer-assisted femoral head reduction osteotomies: an approach for anatomic reconstruction of severely deformed Legg-Calvé-Perthes hips. A pilot study of six patients. BMC Musculoskelet Disord 2020; 21:759. [PMID: 33208124 PMCID: PMC7677844 DOI: 10.1186/s12891-020-03789-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 11/11/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Legg-Calvé-Perthes (LCP) is a common orthopedic childhood disease that causes a deformity of the femoral head and to an adaptive deformity of the acetabulum. The altered joint biomechanics can result in early joint degeneration that requires total hip arthroplasty. In 2002, Ganz et al. introduced the femoral head reduction osteotomy (FHRO) as a direct joint-preserving treatment. The procedure remains one of the most challenging in hip surgery. Computer-based 3D preoperative planning and patient-specific navigation instruments have been successfully used to reduce technical complexity in other anatomies. The purpose of this study was to report the first results in the treatment of 6 patients to investigate whether our approach is feasible and safe. METHODS In this retrospective pilot study, 6 LCP patients were treated with FHRO in multiple centers between May 2017 and June 2019. Based on patient-specific 3D-models of the hips, the surgeries were simulated in a step-wise fashion. Patient-specific instruments tailored for FHRO were designed, 3D-printed and used in the surgeries for navigating the osteotomies. The results were assessed radiographically [diameter index, sphericity index, Stulberg classification, extrusion index, LCE-, Tönnis-, CCD-angle and Shenton line] and the time and costs were recorded. Radiologic values were tested for normal distribution using the Shapiro-Wilk test and for significance using Wilcoxon signed-rank test. RESULTS The sphericity index improved postoperatively by 20% (p = 0.028). The postoperative diameter of the femoral head differed by only 1.8% (p = 0.043) from the contralateral side and Stulberg grading improved from poor coxarthrosis outcome to good outcome (p = 0.026). All patients underwent acetabular reorientation by periacetabular osteotomy. The average time (in minutes) for preliminary analysis, computer simulation and patient-specific instrument design was 63 (±48), 156 (±64) and 105 (±68.5), respectively. CONCLUSION The clinical feasibility of our approach to FHRO has been demonstrated. The results showed significant improvement compared to the preoperative situation. All operations were performed by experienced surgeons; nevertheless, three complications occurred, showing that FHRO remains one of the most complex hip surgeries even with computer assistance. However, none of the complications were directly related to the simulation or the navigation technique.
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Affiliation(s)
- P. Fürnstahl
- Research in Orthopedic Computer Science (ROCS), Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - F. A. Casari
- Research in Orthopedic Computer Science (ROCS), Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Orthopedic Department, Balgrist University Hospital, Zurich, Switzerland
| | - J. Ackermann
- Research in Orthopedic Computer Science (ROCS), Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Institute for Orthopedic Biomechanics, ETH Zurich, Zurich, Switzerland
| | - M. Marcon
- Radiology Department, Balgrist University Hospital, Zurich, Switzerland
| | - M. Leunig
- Schulthess Clinic, Zurich, Switzerland
| | - R. Ganz
- Faculty of Medicine, University of Berne, Berne, Switzerland
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Ackermann J, Holthaus B, Wedel T, Baier M, Maass N, Mettler L, Peters G, Alkatout I. Demonstration of clinical anatomy by laparoscopy on human body donor embalmed by ethanol-glycerol-lysoformin fixation on live surgery events for minimally invasive surgery. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- J Ackermann
- Klinik für Gynäkologie und Geburtshilfe UKSH Campus Kiel
| | - B Holthaus
- Klinik für Gynäkologie und Geburtshilfe, Krankenhaus St. Elisabeth gGmbH
| | - T Wedel
- Institut für Anatomie, Christian-Albrechts-Universität
| | - M Baier
- Klinik für Gynäkologie und Geburtshilfe UKSH Campus Kiel
| | - N Maass
- Klinik für Gynäkologie und Geburtshilfe UKSH Campus Kiel
| | - L Mettler
- Klinik für Gynäkologie und Geburtshilfe UKSH Campus Kiel
| | - G Peters
- Klinik für Gynäkologie und Geburtshilfe UKSH Campus Kiel
| | - I Alkatout
- Klinik für Gynäkologie und Geburtshilfe UKSH Campus Kiel
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20
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Pape J, Ackermann J, Schott S, Vogler F, Baumann J, Pahls J, Maass N, Alkatout I. Implementierung eines Ausbildungskurses für minimalinvasive Chirurgie in das Medizinstudium und Vergleich mit einem etablierten Kurs für Ärzte. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- J. Pape
- Universitätsklinikum Schleswig-Holstein, Campus Kiel/Gynäkologie und Geburtshilfe
| | - J. Ackermann
- Universitätsklinikum Schleswig-Holstein, Campus Kiel/Gynäkologie und Geburtshilfe
| | - S. Schott
- Universitätsklinikum Schleswig-Holstein, Campus Kiel/Gynäkologie und Geburtshilfe
| | - F. Vogler
- Universitätsklinikum Schleswig-Holstein, Campus Kiel/Gynäkologie und Geburtshilfe
| | - J. Baumann
- Universitätsklinikum Schleswig-Holstein, Campus Kiel/Gynäkologie und Geburtshilfe
| | - J. Pahls
- Universitätsklinikum Schleswig-Holstein, Campus Kiel/Gynäkologie und Geburtshilfe
| | - N. Maass
- Universitätsklinikum Schleswig-Holstein, Campus Kiel/Gynäkologie und Geburtshilfe
| | - I. Alkatout
- Universitätsklinikum Schleswig-Holstein, Campus Kiel/Gynäkologie und Geburtshilfe
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Westermann A, Limpach M, Ackermann J, Maass N, Heinrichs B, Alkatout I. Ethische Betrachtung der operativen Ausbildung im Kontext moderner operativer Verfahren. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
| | | | - J. Ackermann
- Klinik für Gynäkologie und Geburtshilfe UKSH Campus Kiel
| | - N. Maass
- Klinik für Gynäkologie und Geburtshilfe UKSH Campus Kiel
| | | | - I. Alkatout
- Klinik für Gynäkologie und Geburtshilfe UKSH Campus Kiel
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22
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Ackermann J, Wedel T, Holthaus B, Bojahr B, Hackethal A, Brucker S, Biebl M, Westermann M, Günther V, Krüger M, Maass N, Mettler L, Peters G, Alkatout I. Didactic Benefits of Surgery on Body Donors during Live Surgery Events in Minimally Invasive Surgery. J Clin Med 2020; 9:jcm9092912. [PMID: 32917056 PMCID: PMC7563950 DOI: 10.3390/jcm9092912] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 12/11/2022] Open
Abstract
Background: Live surgery events serve as a valuable tool for surgical education, but also raise ethical concerns about patient safety and professional performance. In the present study, we evaluate the technical feasibility and didactic benefits of live surgery on body donors compared to real patients. Methods: A live surgery session performed on a body donor’s cadaver embalmed in ethanol–glycerol–lysoformin was integrated into the live surgery program presented at a major gynecological convention of minimally invasive surgery. Surgical procedures carried out in real patients were paralleled in the body donor, including the dissection and illustration of surgically relevant anatomical landmarks. A standardized questionnaire was filled by the participants (n = 208) to evaluate the appropriateness, effectiveness, and benefits of this novel concept. Results: The live surgery event was appreciated as a useful educational tool. With regard to the use of body donors, authenticity was rated high (85.5%), and the overall value of body donors for surgical education and training was rated very high (95.0%). The didactic benefit of simultaneous operations performed on body donors and real patients was considered particularly useful (95.5%), whereas complete replacement of real patients by body donors was not favored (14.5%). Conclusions: The study demonstrated both the technical feasibility and didactic benefits of performing minimally invasive surgery in body donors as part of live surgery events. This novel concept has the potential to enhance anatomical knowledge, providing insights into complex surgical procedures, and may serve to overcome yet unresolved ethical concerns related to live surgery events.
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Affiliation(s)
- Johannes Ackermann
- Department of Obstetrics and Gynecology, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, House C, 24105 Kiel, Germany; (J.A.); (M.W.); (V.G.); (M.K.); (N.M.); (L.M.); (G.P.)
| | - Thilo Wedel
- Institute of Anatomy, Christian-Albrechts University Kiel, Otto-Hahn-Platz 8, 24118 Kiel, Germany;
| | - Bernd Holthaus
- Clinic of Obstetrics and Gynecology, St. Elisabeth Hospital, 49401 Damme, Germany;
| | - Bernd Bojahr
- Clinic of Minimally Invasive Surgery, Kurstraße 11, 14129 Berlin-Zehlendorf, Germany;
| | | | - Sara Brucker
- Department für Frauengesundheit, University Hospital Tübingen, Calwer Straße 7, 72076 Tübingen, Germany;
| | - Matthias Biebl
- Department of Surgery, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany;
| | - Martina Westermann
- Department of Obstetrics and Gynecology, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, House C, 24105 Kiel, Germany; (J.A.); (M.W.); (V.G.); (M.K.); (N.M.); (L.M.); (G.P.)
| | - Veronika Günther
- Department of Obstetrics and Gynecology, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, House C, 24105 Kiel, Germany; (J.A.); (M.W.); (V.G.); (M.K.); (N.M.); (L.M.); (G.P.)
| | - Magret Krüger
- Department of Obstetrics and Gynecology, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, House C, 24105 Kiel, Germany; (J.A.); (M.W.); (V.G.); (M.K.); (N.M.); (L.M.); (G.P.)
| | - Nicolai Maass
- Department of Obstetrics and Gynecology, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, House C, 24105 Kiel, Germany; (J.A.); (M.W.); (V.G.); (M.K.); (N.M.); (L.M.); (G.P.)
| | - Liselotte Mettler
- Department of Obstetrics and Gynecology, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, House C, 24105 Kiel, Germany; (J.A.); (M.W.); (V.G.); (M.K.); (N.M.); (L.M.); (G.P.)
| | - Göntje Peters
- Department of Obstetrics and Gynecology, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, House C, 24105 Kiel, Germany; (J.A.); (M.W.); (V.G.); (M.K.); (N.M.); (L.M.); (G.P.)
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, House C, 24105 Kiel, Germany; (J.A.); (M.W.); (V.G.); (M.K.); (N.M.); (L.M.); (G.P.)
- Correspondence: ; Tel.: +49-431-500-21450
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23
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Blumberg C, Liborius L, Ackermann J, Tegude FJ, Poloczek A, Prost W, Weimann N. Spatially controlled VLS epitaxy of gallium arsenide nanowires on gallium nitride layers. CrystEngComm 2020. [DOI: 10.1039/c9ce01926j] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
MOVPE of Au catalyzed p-GaAs nanowires on n-GaN layers. Left: VLS growth optimization (density and morphology). Middle and right: site-controlled pn-junctions by lateral and vertical anisotropic NWs in structured SiOx openings (scalebar 1 μm).
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Affiliation(s)
- C. Blumberg
- University of Duisburg-Essen
- Dept. Components for High Frequency Electronics
- Faculty of Engineering, and CENIDE
- Duisburg
- Germany
| | - L. Liborius
- University of Duisburg-Essen
- Dept. Components for High Frequency Electronics
- Faculty of Engineering, and CENIDE
- Duisburg
- Germany
| | - J. Ackermann
- University of Duisburg-Essen
- Dept. Components for High Frequency Electronics
- Faculty of Engineering, and CENIDE
- Duisburg
- Germany
| | - F.-J. Tegude
- University of Duisburg-Essen
- Dept. Components for High Frequency Electronics
- Faculty of Engineering, and CENIDE
- Duisburg
- Germany
| | - A. Poloczek
- University of Duisburg-Essen
- Dept. Components for High Frequency Electronics
- Faculty of Engineering, and CENIDE
- Duisburg
- Germany
| | - W. Prost
- University of Duisburg-Essen
- Dept. Components for High Frequency Electronics
- Faculty of Engineering, and CENIDE
- Duisburg
- Germany
| | - N. Weimann
- University of Duisburg-Essen
- Dept. Components for High Frequency Electronics
- Faculty of Engineering, and CENIDE
- Duisburg
- Germany
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24
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Ackermann J, Krueger A. Efficient surface functionalization of detonation nanodiamond using ozone under ambient conditions. Nanoscale 2019; 11:8012-8019. [PMID: 30946413 DOI: 10.1039/c9nr01716j] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Oxidative treatment is an important method for the purification and functionalization of carbon nanomaterials. Here we report on the treatment of detonation diamond particles with ozone at low temperatures. The homogeneous reaction in colloidal dispersion opens up a novel path for the efficient and homogeneous functionalization of the surface of nanodiamond with ozonides. As these are stable under the chosen ozonolysis conditions, they can be transformed to a number of different surface groups in subsequent oxidative or reductive workup steps. This versatile method for the preparation of oxygen-terminated diamond nanoparticles provides excellent control over the composition of the surface moieties in a waste-free and easy to set up way.
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Affiliation(s)
- Johannes Ackermann
- Institute for Organic Chemistry, Julius-Maximilians University Würzburg, Am Hubland, D-97074 Würzburg, Germany.
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25
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Pahls J, Ackermann J, Holthaus B, Noé G, Maass N, Alkatout I. Entwicklung einer Methode zur initialen Leistungseinstufung für einen besseren individuellen Lernerfolg in Trainingskursen für operative Laparoskopie. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671403] [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] Open
Affiliation(s)
- J Pahls
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, School of Gynaecological Endoscopy, Kiel, Deutschland
| | - J Ackermann
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, School of Gynaecological Endoscopy, Kiel, Deutschland
| | - B Holthaus
- Klinik für Gynäkologie und Geburtshilfe, Krankenhaus St. Elisabeth, Damme, Deutschland
| | - G Noé
- Klinik für Gynäkologie und Geburtshilfe, Kreiskrankenhaus Dormagen, Dormagen, Deutschland
| | - N Maass
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, School of Gynaecological Endoscopy, Kiel, Deutschland
| | - I Alkatout
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, School of Gynaecological Endoscopy, Kiel, Deutschland
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Baumann J, Ackermann J, Holthaus B, Noé G, Maass N, Alkatout I. Evaluation eines neuartigen Pelvitrainers im Rahmen eines strukturierten Kurses für minimalinvasive Chirurgie in einem interdisziplinären und multizentrischen Setting. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671082] [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] Open
Affiliation(s)
- J Baumann
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel School of Gynaecological Endoscopy, Kiel, Deutschland
| | - J Ackermann
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel School of Gynaecological Endoscopy, Kiel, Deutschland
| | - B Holthaus
- Klinik für Gynäkologie und Geburtshilfe, Krankenhaus St. Elisabeth, Damme, Deutschland
| | - G Noé
- Klinik für Gynäkologie und Geburtshilfe, Kreiskrankenhaus Dormagen, Dormagen, Deutschland
| | - N Maass
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel School of Gynaecological Endoscopy, Kiel, Deutschland
| | - I Alkatout
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel School of Gynaecological Endoscopy, Kiel, Deutschland
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27
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Ackermann J, Hagedorn H, Maass N, Wedel T, Alkatout I. The glycerin-based cadaver preservation – A technique that enables training of laparoscopic surgery on human body donor. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671081] [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] Open
Affiliation(s)
- J Ackermann
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein Campus Kiel, Kiel, Deutschland
| | - H Hagedorn
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein Campus Kiel, Kiel, Deutschland
| | - N Maass
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein Campus Kiel, Kiel, Deutschland
| | - T Wedel
- Anatomisches Institut der Christian-Albrechts-Universität zu Kiel, Kiel, Deutschland
| | - I Alkatout
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein Campus Kiel, Kiel, Deutschland
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28
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Karlstetter M, Kopatz J, Aslanidis A, Shahraz A, Caramoy A, Linnartz-Gerlach B, Lin Y, Lückoff A, Fauser S, Düker K, Claude J, Wang Y, Ackermann J, Schmidt T, Hornung V, Skerka C, Langmann T, Neumann H. Polysialic acid blocks mononuclear phagocyte reactivity, inhibits complement activation, and protects from vascular damage in the retina. EMBO Mol Med 2017; 9:154-166. [PMID: 28003336 PMCID: PMC5286381 DOI: 10.15252/emmm.201606627] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Age‐related macular degeneration (AMD) is a major cause of blindness in the elderly population. Its pathophysiology is linked to reactive oxygen species (ROS) and activation of the complement system. Sialic acid polymers prevent ROS production of human mononuclear phagocytes via the inhibitory sialic acid‐binding immunoglobulin‐like lectin‐11 (SIGLEC11) receptor. Here, we show that low‐dose intravitreal injection of low molecular weight polysialic acid with average degree of polymerization 20 (polySia avDP20) in humanized transgenic mice expressing SIGLEC11 on mononuclear phagocytes reduced their reactivity and vascular leakage induced by laser coagulation. Furthermore, polySia avDP20 prevented deposition of the membrane attack complex in both SIGLEC11 transgenic and wild‐type animals. In vitro, polySia avDP20 showed two independent, but synergistic effects on the innate immune system. First, polySia avDP20 prevented tumor necrosis factor‐α, vascular endothelial growth factor A, and superoxide production by SIGLEC11‐positive phagocytes. Second, polySia avDP20 directly interfered with complement activation. Our data provide evidence that polySia avDP20 ameliorates laser‐induced damage in the retina and thus is a promising candidate to prevent AMD‐related inflammation and angiogenesis.
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Affiliation(s)
- Marcus Karlstetter
- Laboratory for Experimental Immunology of the Eye, Department of Ophthalmology, University of Cologne, Cologne, Germany.,Therapeutic Research Group Ophthalmology, Bayer Pharma AG, Wuppertal, Germany
| | - Jens Kopatz
- Institute of Reconstructive Neurobiology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Alexander Aslanidis
- Laboratory for Experimental Immunology of the Eye, Department of Ophthalmology, University of Cologne, Cologne, Germany
| | - Anahita Shahraz
- Institute of Reconstructive Neurobiology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Albert Caramoy
- Laboratory for Experimental Immunology of the Eye, Department of Ophthalmology, University of Cologne, Cologne, Germany
| | - Bettina Linnartz-Gerlach
- Institute of Reconstructive Neurobiology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Yuchen Lin
- Leibniz Institute for Natural Product Research and Infection Biology, Jena, Germany
| | - Anika Lückoff
- Laboratory for Experimental Immunology of the Eye, Department of Ophthalmology, University of Cologne, Cologne, Germany
| | - Sascha Fauser
- Laboratory for Experimental Immunology of the Eye, Department of Ophthalmology, University of Cologne, Cologne, Germany
| | - Katharina Düker
- Institute of Reconstructive Neurobiology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Janine Claude
- Institute of Reconstructive Neurobiology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Yiner Wang
- Institute of Reconstructive Neurobiology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Johannes Ackermann
- Institute of Reconstructive Neurobiology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Tobias Schmidt
- Institute of Molecular Medicine, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Veit Hornung
- Institute of Molecular Medicine, University Hospital Bonn, University of Bonn, Bonn, Germany.,Gene Center and Department of Biochemistry, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Christine Skerka
- Leibniz Institute for Natural Product Research and Infection Biology, Jena, Germany
| | - Thomas Langmann
- Laboratory for Experimental Immunology of the Eye, Department of Ophthalmology, University of Cologne, Cologne, Germany
| | - Harald Neumann
- Institute of Reconstructive Neurobiology, University Hospital Bonn, University of Bonn, Bonn, Germany
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29
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Abstract
Two different types of metastable states in Ne2+2 are predicted and possible decay transitions as well as the ensuing lifetimes and intensity distributions are studied.
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Affiliation(s)
- J. Ackermann
- Molecular Bioinformatics
- Johann Wolfgang Goethe Universität
- D-60325 Frankfurt
- Germany
| | - H. Hogreve
- IFISR – International Foundation for Independent Scientific Research
- New York
- USA
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30
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Abstract
Robotic surgery is the most dynamic development in the sector of minimally invasive operations currently. It should not be viewed as an alternative to laparoscopy, but as the next step in a process of technological evolution. The advancement of robotic surgery, in terms of the introduction of the Da Vinci Xi, permits the variable use of optical devices in all four trocars. Due to the new geometry of the "patient cart," an operation can be performed in all spatial directions without re-docking. Longer instruments and the markedly narrower mechanical elements of the "patient cart" provide greater flexibility as well as access similar to those of traditional laparoscopy. Currently, robotic surgery is used for a variety of indications in the treatment of benign gynecological diseases as well as malignant ones. Interdisciplinary cooperation and cooperation over large geographical distances have been rendered possible by telemedicine, and will ensure comprehensive patient care in the future by highly specialized surgery teams. In addition, the second operation console and the operation simulator constitute a new dimension in advanced surgical training. The disadvantages of robotic surgery remain the high costs of acquisition and maintenance as well as the laborious training of medical personnel before they are confident with using the technology.
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Affiliation(s)
- Ibrahim Alkatout
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Liselotte Mettler
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Nicolai Maass
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Johannes Ackermann
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany
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31
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Ackermann J, Kanzow M, Mathiak M, Pecks U, Maass N, Alkatout I. Endoscopic removal of a retained surgical sponge in a young Syrian refugee after Caesarean section: a case report with discussion of cultural and political consequences. Patient Saf Surg 2016; 10:22. [PMID: 27800018 PMCID: PMC5080713 DOI: 10.1186/s13037-016-0111-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 10/13/2016] [Indexed: 11/24/2022] Open
Abstract
Background Inadvertently retained sponges and instruments still constitute a major but preventable complication in surgery. Given the high geographic mobility of patients, the fluctuation of physician-patient contact, and communication problems due to language barriers, the conscientious use of structured safety protocols in clinical routine is an essential aspect of quality in health care. Case presentation We report the case of a 24-year-old refugee from Syria who presented at our gynecological outpatient department with a tumor in the lower abdomen, suspected to be a lump in the ovary or the uterus. Language barriers hindered exact recording of the patient’s medical history. We knew she had undergone three Caesarean sections several years ago. The diagnostic laparoscopy unexpectedly revealed a tumor suspected to be a retained surgical sponge. The lesion was removed completely and the patient discharged from the clinic five days later. Conclusion In ambiguous cases, the diagnostic and therapeutic potential of minimally invasive surgery ensures safe and effective treatment of the patient, a short hospital stay, and low rates of complications. Especially in cases of language and/or cultural barriers, structured safety protocols should be a part of clinical routine in order to prevent unnecessary complications.
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Affiliation(s)
- Johannes Ackermann
- Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus 24, 24105 Kiel, Germany
| | - Moritz Kanzow
- Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus 24, 24105 Kiel, Germany
| | - Micaela Mathiak
- Institute of Pathology, University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany
| | - Ulrich Pecks
- Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus 24, 24105 Kiel, Germany
| | - Nicolai Maass
- Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus 24, 24105 Kiel, Germany
| | - Ibrahim Alkatout
- Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus 24, 24105 Kiel, Germany
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32
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Abstract
Access to pseudotetrahedral [Tc(NO)(Cp)(PPh3)X]0,+complexes (X = halide, Ph, CO) has been found by a convenient procedure starting from [Tc(NO)Y2(PPh3)2(MeCN)] (Y = Cl, Br) and subsequent ligand exchange reactions.
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Affiliation(s)
- J. Ackermann
- Freie Universität Berlin
- Institute of Chemistry and Biochemistry
- D-14195 Berlin
- Germany
| | - A. Hagenbach
- Freie Universität Berlin
- Institute of Chemistry and Biochemistry
- D-14195 Berlin
- Germany
| | - U. Abram
- Freie Universität Berlin
- Institute of Chemistry and Biochemistry
- D-14195 Berlin
- Germany
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33
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Abstract
The design of DNA sequences plays a fundamental role for many biomolecular applications and is one of the most important theoretical tasks to fathom the potential of molecular information processing. Optimization strategies have been based on the model of stiff “digital” polymers by counting the number of base mismatches (Hamming distance and related distances). In this work we show the limitation of such a combinatorial approach because of the ability of DNA to build more complex structures. We develop a model platform to optimize word sets according to all possible secondary structures occurring for the relevant word-word interactions. The fidelity of the hybridization reactions can be improved significantly and as an example of a set of 24 words of 16-mers we show that the optimal set has unique physical properties, such as binding energy, melting temperature, and G+C content.
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Affiliation(s)
- J. Ackermann
- Fraunhofer Gesellschaft, Schloss Birlinghoven, D-53754 Sankt Augustin
| | - F.-U. Gast
- Justus-Liebig-Universitäat Gießen, Institut für Anorganische und Analytische Chemie, Schubertstraße 60, Haus 16, D-35392 Gießen
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Ackermann J, Einloft J, Nöthen J, Koch I. Reduction techniques for network validation in systems biology. J Theor Biol 2012; 315:71-80. [PMID: 22982289 DOI: 10.1016/j.jtbi.2012.08.042] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Revised: 08/27/2012] [Accepted: 08/29/2012] [Indexed: 10/27/2022]
Abstract
The rapidly increasing amount of experimental biological data enables the development of large and complex, often genome-scale models of molecular systems. The simulation and analysis of these computer models of metabolism, signal transduction, and gene regulation are standard applications in systems biology, but size and complexity of the networks limit the feasibility of many methods. Reduction of networks provides a hierarchical view of complex networks and gives insight knowledge into their coarse-grained structural properties. Although network reduction has been extensively studied in computer science, adaptation and exploration of these concepts are still lacking for the analysis of biochemical reaction systems. Using the Petri net formalism, we describe two local network structures, common transition pairs and minimal transition invariants. We apply these two structural elements for network reduction. The reduction preserves the CTI-property (covered by transition invariants), which is an important feature for completeness of biological models. We demonstrate this concept for a selection of metabolic networks including a benchmark network of Saccharomyces cerevisiae whose straightforward treatment is not yet feasible even on modern supercomputers.
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Affiliation(s)
- J Ackermann
- Department of Molecular Bioinformatics, Johann Wolfgang Goethe-University Frankfurt am Main, Institute of Computer Science, Robert-Mayer-Str. 11-15, 60325 Frankfurt am Main, Germany
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Rotter T, Uffmann D, Ackermann J, Aderhold J, Stemmer J, Graul J. Current Controlled Photoelectrochemical Etching of Gan Leaving Smooth Surfaces. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-482-1003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AbstractWe have etched GaN grown by plasma source MBE in aqueous solutions of KOH in an electrochemical cell under HeCd laser illumination and additional current control.The etch rate was dramatically enhanced up to 8 μm/h by an applied current density of 6.4 mAcm-2. Photocurrent control leads to etched GaN surfaces exhibiting mirror-like appearance with uniform interference color. According to mechanical profilometry, they have a roughness of less than 3.5 nm after etching of several hundred nanometers, which is comparable to the roughness prior to etching. This etching process allows in situ control via photocurrent and induced yellow luminescence.
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36
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Ackermann J. „Outside-the-Box Innovations”︁ - Das Projekthauskonzept von Evonik Industries. CHEM-ING-TECH 2009. [DOI: 10.1002/cite.200950038] [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: 11/10/2022]
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37
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Kees M, Dimou G, Sillaber C, Drach J, Ackermann J, Lechner K, Gisslinger H. Low Dose Thalidomide in Patients with Relapsed or Refractory Multiple Myeloma. Leuk Lymphoma 2009; 44:1943-6. [PMID: 14738147 DOI: 10.1080/1042819031000123492] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Remarkable results of the treatment of refractory multiple myeloma with thalidomide have been reported. In most preceding studies, the given thalidomide dose was escalated to a maximum tolerated dose of up to 800 mg/d. The frequency of adverse effects correlates with dose intensity. Since a significant gain of therapeutic effects could not be observed as thalidomide dosage was escalated, the optimal dose of thalidomide remains to be determined. We report the results of a study with low dose thalidomide (median administered dose 100 mg/d, range 50-400 mg/d). Twenty-four relapsed (n = 19) or resistant (n = 5) multiple myeloma patients were included in the study. Twelve patients (50%) received thalidomide as monotherapy, 8 patients (33%) received a combination of thalidomide and dexamethasone (every 4 weeks 40 mg/day for 4 days) and 4 patients (17%) who were resistant to vincristine, doxorubicin, dexamethasone (VAD) received VAD combined with thalidomide. Overall, a response was observed in 12 patients (50%). Of the 12 patients treated with low dose thalidomide alone 5 (42%) responded, of the 8 patients who received a combination of thalidomide and dexamethasone 5 (63%) responded and of the 4 patients who had thalidomide in addition to VAD 2 patients (50%) responded. In 3 patients, thalidomide treatment had to be discontinued because of side effects and 1 patient died before response could be assessed. We conclude that low dose thalidomide is an effective and safe rescue therapy in relapsing or refractory multiple myeloma. Response to thalidomide might be dependent on prognostic parameters and tumor burden. To answer these questions larger prospective studies are necessary.
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Affiliation(s)
- M Kees
- Division of Haematology and Blood Coagulation, Department of Internal Medicine I, University of Vienna, Vienna, Austria
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38
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39
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Kaufmann H, Ackermann J, Odelga V, Sagaster V, Nösslinger T, Pfeilstöcker M, Keck A, Ludwig H, Gisslinger H, Drach J. Cytogenetic patterns in multiple myeloma after a phase of preceding MGUS. Eur J Clin Invest 2008; 38:53-60. [PMID: 18173551 DOI: 10.1111/j.1365-2362.2007.01903.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Presenting the same histological diagnosis, multiple myeloma (MM) shows a large genomic variety, resulting in variable times of overall survival. MATERIALS AND METHODS To investigate major cytogenetic categories (any 14q-translocation, t(11;14), t(4;14), 13q-deletions, 17p-deletions) and their clinical consequences in MM after a pre-existing monoclonal gammopathy (MM post-MGUS), we performed a comparative analysis of 41 patients with MM post-MGUS and 287 patients with unknown prior history MM (U-MM). RESULTS In MM post-MGUS, a t(11;14) was found to be more frequent than in U-MM (24% vs. 14%) and it was associated with significantly shortened survival (24 months vs. 70 months in U-MM; P = 0.01). MM post-MGUS was further characterized by a higher frequency of 13q-deletions only (absence of all other specific abnormalities; 28% vs. 12% in U-MM; P = 0.02). A 13q-deletion only was an indicator of long survival in MM post-MGUS (median not yet reached) as opposed to U-MM (median survival, 29 months; P = 0.001). 17p-deletions were infrequent in MM post-MGUS (3% vs. 16% in U-MM; P = 0.04). Survival times for patients with t(4;14) and/or 17p-deletions and other abnormalities were similar in both MM patient cohorts. CONCLUSIONS Our data suggest that t(11;14) and 13q-deletions have distinct prognostic implications in the context of MM post-MGUS.
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Affiliation(s)
- H Kaufmann
- Medical University of Vienna, Department of Medicine I, Vienna, Austria.
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40
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Yoshimoto N, Aosawa K, Taniswa T, Omote K, Ackermann J, Videlot-Ackermann C, Brisset H, Fages F. Characterization of in-plane structures of vapor deposited thin-films of distyryl-oligothiophenes by grazing incidence x-ray diffractometry. Cryst Res Technol 2007. [DOI: 10.1002/crat.200711010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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41
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Sagaster V, Kaufmann H, Odelga V, Ackermann J, Gisslinger H, Rabitsch W, Zojer N, Ludwig H, Nösslinger T, Zielinski C, Drach J. Chromosomal abnormalities of young multiple myeloma patients (<45 yr) are not different from those of other age groups and are independent of stage according to the International Staging System. Eur J Haematol 2007; 78:227-34. [PMID: 17253972 DOI: 10.1111/j.1600-0609.2006.00807.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Little is known about tumor-related prognostic factors, in particular specific chromosomal abnormalities, in young patients with multiple myeloma (MM). We therefore investigated the chromosomal pattern by interphase fluorescence in situ hybridization (chromosomes 13q14, 14q32-translocations, chromosomes associated with hyperdiploidy) in 38 young patients with MM (age <45 yr) and compared the results with those observed in 69 patients with intermediate age (45-70 yr) and 64 elderly patients (age >70 yr). All chromosomal patterns were not significantly different between the three age cohorts. Similarly, standard MM parameters were equally distributed between these MM patient populations. However, survival by the International Staging System (ISS) for MM revealed marked differences between stage I/II (median survival not yet reached) and stage III (23.4 months; P < 0.0003) among young MM patients. A significant survival difference between ISS-stage I/II and ISS-stage III patients was also noted in the intermediate age group (median 65.4 months vs. 24.6 months; P = 0.0009). However, this difference disappeared among elderly MM patients (39.6 months in ISS-stage I/II vs. 32 months in ISS-stage III patients; P = 0.94), but it was unrelated to the cytogenetic pattern. Our results indicate that MM in young patients does not represent a distinct biologic entity, and that short survival of younger MM patients at ISS-stage III is independent of the molecular cytogenetic pattern.
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Affiliation(s)
- V Sagaster
- Department of Internal Medicine I, Clinical Division of Oncology, Medical University of Vienna, Vienna, Austria
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42
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Sagaster V, Ludwig H, Kaufmann H, Odelga V, Zojer N, Ackermann J, Küenburg E, Wieser R, Zielinski C, Drach J. Bortezomib in relapsed multiple myeloma: response rates and duration of response are independent of a chromosome 13q-deletion. Leukemia 2006; 21:164-8. [PMID: 17096015 DOI: 10.1038/sj.leu.2404459] [Citation(s) in RCA: 102] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Studies of bortezomib in patients with relapsed multiple myeloma (MM) suggested that bortezomib may be active even in the presence of adverse prognostic factors. We therefore evaluated 62 patients with relapsed/refractory MM who were treated with single-agent bortezomib, and addressed the question whether or not the negative prognostic impact of unfavorable cytogenetic abnormalities may be overcome by bortezomib. By interphase fluorescence in situ hybridization (FISH), a deletion of chromosome 13q14 [del(13q14)] was present in 33 patients (53%). Overall response rates to bortezomib were similar in patients with and without del(13q14) (45 versus 55%; P=0.66), and rates of complete remission (CR) near CR were also not different between the two patient populations (18 versus 14%). Three patients had a t(4;14)(p16;q32) in addition to del(13q14), and all of them had a >50% paraprotein reduction. Median duration of response was 12.3 months in patients with del(13q14) compared with 9.3 months in patients with normal 13q-status (P=0.25), and survival was also not different between the two patient populations. Patients not benefiting from single-agent bortezomib were characterized by the combined presence of a del(13q14) and low serum albumin (median survival 4.6 months). Our results provide evidence for remarkable activity of bortezomib in MM with del(13q14). Patients who do not respond to bortezomib and consecutively have short time to treatment failure and overall survival can be identified by low serum albumin in addition to del(13q14) and should be considered for bortezomib combinations.
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Affiliation(s)
- V Sagaster
- Department of Internal Medicine I, Clinical Division of Oncology, Medical University of Vienna, Vienna, Austria
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43
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Affiliation(s)
- J. Ackermann
- a I. N. Stranski Institut, Technische Universität Berlin , D-1000 , Berlin 10 , F.R. Germany
| | - H. Hogreve
- b Hahn-Meitner Institut Berlin , Postfach 390128, D-1000 , Berlin 39 , F.R. Germany
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44
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Bellini B, Ackermann J, Klein H, Dumas P, Safarov V. Light-induced random-walk motion in azo-polymers. Materials Science and Engineering: C 2005. [DOI: 10.1016/j.msec.2005.06.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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45
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Kaufmann H, Ackermann J, Baldia C, Nösslinger T, Wieser R, Seidl S, Sagaster V, Gisslinger H, Jäger U, Pfeilstöcker M, Zielinski C, Drach J. Both IGH translocations and chromosome 13q deletions are early events in monoclonal gammopathy of undetermined significance and do not evolve during transition to multiple myeloma. Leukemia 2004; 18:1879-82. [PMID: 15385925 DOI: 10.1038/sj.leu.2403518] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Molecular and genetic events associated with the transition from monoclonal gammopathy of undetermined significance (MGUS) to multiple myeloma (MM) are still poorly characterized. We investigated serial bone marrow specimens from 11 patients with MGUS who eventually progressed to MM (MM post-MGUS) by interphase fluorescence in situ hybridization for immunoglobulin heavy-chain gene (IgH) translocations and chromosome 13q deletions (del(13q)). In nine patients, IgH translocations were present both in MGUS and MM post-MGUS plasma cells, including three t(11;14)(q13;q32) and one t(4;14)(p16;q32), which was observed already 92 months prior to MM. Similarly, all five MM patients with del(13q) had this aberration already at the MGUS stage. Two patients without IgH translocation and del(13q) had chromosomal gains suggesting hyperdiploidy, but IgH translocations and/or del(13q) did not emerge at MM post-MGUS. IgH translocations and del(13q) are early genetic events in monoclonal gammopathies, suggesting that additional events are required for the transition from stable MGUS to progressive MM.
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Affiliation(s)
- H Kaufmann
- Department of Medicine I, Medical University of Vienna, Vienna, Austria
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46
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Simonitsch-Klupp I, Hauser I, Ott G, Drach J, Ackermann J, Kaufmann J, Weltermann A, Greinix HT, Skrabs C, Dittrich C, Lutz D, Pötter R, Mannhalter C, Lechner K, Chott A, Jaeger U. Diffuse large B-cell lymphomas with plasmablastic/plasmacytoid features are associated with TP53 deletions and poor clinical outcome. Leukemia 2004; 18:146-55. [PMID: 14603341 DOI: 10.1038/sj.leu.2403206] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
To define reproducible criteria for subgroups of diffuse large B-cell lymphomas (DLBCL), including lymphomas with plasmablastic/plasmacytoid features (PB/PC-Fs), we investigated 66 DLBCL; the samples were categorized as either centroblastic (CB), immunoblastic (IB) or PB/PC-F applying standardized morphologic criteria. Blinded specimens were reviewed by three independent pathologists. The final consensus classification included 44 CB (67%), seven IB (10%) and 15 PB/PC-F (23%). The interobserver agreement between two centers (Vienna, Würzburg) was 93.5%. Most PB/PC-F were CD20+, cIgM+, MUM-1+, CD138+/-, bcl-6-, corresponding to an activated B-cell phenotype. Immunoglobulin-V(H) gene mutation analysis was consistent with a germinal or postgerminal center-cell origin. By fluorescence in situ hybridization analysis, 11/13 (85%) PB/PC-F had a monoallelic TP53 deletion. The pretreatment characteristics of patients with PB/PC-F included a tendency for more B symptoms, extranodal disease and a higher IPI. Importantly, PB/PC-F were resistant to standard chemotherapy (complete remission rate 47%, relapse rate 71%) and even autologous stem-cell transplantation. The median overall survival (OS) (14 months, P<0.002) and disease-free survival (6 months, P=0.02) were significantly shorter compared to patients with CB and IB. The OS difference was pronounced within the low and low-intermediate IPI risk group (P<0.001). Our data indicate a strong association of plasmablastic/plasmacytoid morphology with TP53 deletions, poor response to chemotherapy and short survival.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antigens, Neoplasm/analysis
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers/analysis
- Female
- Follow-Up Studies
- Genes, Immunoglobulin
- Genes, p53/genetics
- Germinal Center/immunology
- Herpesvirus 4, Human/genetics
- Humans
- Immunophenotyping
- In Situ Hybridization, Fluorescence
- Lymphoma, B-Cell/classification
- Lymphoma, B-Cell/mortality
- Lymphoma, B-Cell/pathology
- Lymphoma, Large B-Cell, Diffuse/classification
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large-Cell, Immunoblastic/classification
- Lymphoma, Large-Cell, Immunoblastic/mortality
- Lymphoma, Large-Cell, Immunoblastic/pathology
- Male
- Middle Aged
- Plasma Cells/pathology
- Prognosis
- RNA, Viral/genetics
- Sequence Deletion
- Survival Rate
- Treatment Outcome
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47
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Maurer CA, Stamenic I, Stouthandel R, Ackermann J, Gonzenbach HR. Single hemicerclage for lateral type B malleolar fracture--a novel, minimal and reliable osteosynthesis. ACTA ACUST UNITED AC 2004; 9:283-8. [PMID: 14725097 DOI: 10.1024/1023-9332.9.6.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
AIM OF STUDY To investigate the short- and long-term outcome of patients with isolated lateral malleolar fracture type B treated with a single hemicerclage out of metallic wire or PDS cord. METHODS Over an 8-year period 97 patients were treated with a single hemicerclage for lateral malleolar fracture type B and 89 were amenable to a follow-up after mean 39 months, including interview, clinical examination and X-ray controls. RESULTS The median operation time was 35 minutes (range 15-85 min). X-ray controls within the first two postoperative days revealed an anatomical restoration of the upper ankle joint in all but one patient. The complication rate was 8%: hematoma (2 patients), wound infection (2), Sudeck's dystrophy (2) and deep vein thrombosis (1). Full weight-bearing was tolerated at median 6.0 weeks (range 2-26 weeks). No secondary displacement, delayed union or consecutive arthrosis of the upper ankle joint was observed. All but one patient had restored symmetric joint mobility. Ninety-seven percent of patients were satisfied or very satisfied with the outcome. Following bone healing, hemicerclage removal was necessary in 19% of osteosyntheses with metallic wire and in none with PDS cord. CONCLUSION The single hemicerclage is a novel, simple and reliable osteosynthesis technique for isolated lateral type B malleolar fractures and may be considered as an alternative to the osteosynthesis procedures currently in use.
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Affiliation(s)
- C A Maurer
- Surgical Clinic, Hospital of Liestal, Liestal, Switzerland.
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Kaufmann H, Ackermann J, Greinix H, Nösslinger T, Gisslinger H, Keck A, Ludwig H, Worel N, Kalhs P, Zielinski C, Drach J. Beneficial effect of high-dose chemotherapy in multiple myeloma patients with unfavorable prognostic features. Ann Oncol 2003; 14:1667-72. [PMID: 14581276 DOI: 10.1093/annonc/mdg454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
It has been established that high-dose chemotherapy (HDT) improves the therapeutic outcome of patients with multiple myeloma (MM) as compared with standard-dose therapy (SDT); however, little is known about the impact of HDT on different prognostic groups of MM patients. We therefore compared the survival times of 77 patients with previously untreated MM who were enrolled in HDT regimens with those of 64 similar patients <65 years old, who would be eligible for HDT but were treated by SDT. Overall, HDT was superior to SDT with respect to achievement of complete remissions (28% versus 2%; P <0.0001) and improvement of progression-free survival (PFS) (30.2 versus 21.2 months; P = 0.01) as well as overall survival (OS) (median 54.9 versus 49.4 months; P = 0.048). According to the chromosome 13q14 status as determined by fluorescence in situ hybridization and serum levels of beta(2)-microglobulin (beta(2)M), MM patients were separated into a standard-risk group (normal chromosome 13q14 and beta(2)M </=4 mg/l) and a high-risk group (deletion of chromosome 13q14 and/or beta(2)M >4 mg/l). Among patients of the high-risk group, both PFS (26.4 versus 10.7 months; P = 0.004) and OS times (40 versus 23 months; P = 0.05) were longer in patients receiving HDT compared with patients treated by SDT. In the standard-risk group, PFS and OS times were not significantly different between HDT patients and SDT patients. Results of this retrospective analysis suggest that the beneficial effects of HDT are greater in MM patients with high-risk features than in patients with absence of such poor prognostic indicators.
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Affiliation(s)
- H Kaufmann
- Department of Medicine I, Clinical Division of Oncology, University Hospital Vienna, Vienna, Austria
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Abstract
Previously, numerical simulations have shown that evolving systems can be stabilized against emerging parasites by pattern formation in spatially extended flow reactors. Hence, it can be argued that pattern formation is a prerequisite for any experimental investigation of the biochemical evolution of cooperative function. Here, we study a model of an experimental biochemical system for the cooperative in vitro amplification of DNA strands and show that emerging parasites can induce a complex pattern formation even when no pattern formation occurs without parasites. In an adiabatic approximation where the cooperative amplification reaction is assumed to adapt fast to slowly emerging parasites, the parasite concentration itself acts as a Steuer parameter for the selection of various complex patterns. Without such an adiabatic approximation only transient patterns emerge. As any species can grow for very low concentrations, the parasite is able to infect the entire reactor and the system is finally diluted out. In the experimental biochemical system, however, the species are individual molecules and the growth of spatially separated, non-infected regions becomes feasible. Hence a cutoff threshold for the minimal concentration is applied. In these simulations the otherwise lethal infection by parasites induces the formation of spatiotemporal spirals, and this spatial structure help the host and parasitoid species to survive together. These theoretical results describe an inherent property of cooperative reactions and have an important impact on experimental investigations on the molecular evolution and complex function in spatially extended reactors. Since the formation of the complex pattern is restricted either to a rather large cutoff value or a special choice of the kinetic parameters, we, however, conclude that the persistence of evolving cooperative amplification is not possible in a simple reaction-diffusion reactor. Experimental set-ups with patchy environments, e.g. biomolecular amplification in coupled microstructured flow chambers or in microemulsion, are eligible candidates for the observation of such a self-organized pattern selection.
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Affiliation(s)
- T Kirner
- Fraunhofer Gesellschaft, Biomolecular Information Processing, Schloss Birlinghoven, D-53754 Sankt Augustin, Germany
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Schwarzmeier JD, Shehata M, Ackermann J, Hilgarth M, Kaufmann H, Drach J. Simultaneous occurrence of chronic myeloid leukemia and multiple myeloma: evaluation by FISH analysis and in vitro expansion of bone marrow cells. Leukemia 2003; 17:1426-8. [PMID: 12835740 DOI: 10.1038/sj.leu.2402971] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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