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Story F, Lindne V, Tricard T, Korenbaum C, Thiery A, Mouracade P, Lang H. Étude observationnelle de la composante sarcomatoïde des carcinomes rénaux localisés. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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102
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Rouvière O, Puech P, Penna RR, Claudon M, Roy C, Lechevallier FM, Petrucci MD, Rabilloud M, Pethelaz AS, Chambardel MD, Magaud L, Cros F, Delongchamps NB, Boutier R, Bratan F, Brunelle S, Camparo P, Colin P, Correas J, Cornelis F, Cornud F, Descotes J, Eschwege P, Fiard G, Fendler J, Habchi H, Hallouin P, Khairoune A, Lang H, Lebras Y, Malavaud B, Moldovan P, Mottet N, Mozer P, Nevoux P, Pagnoux G, Pasticier G, Portalez D, Potiron E, Timsit M, Villers A, Walz J, Colombel M, Ruffion A, Crouzet S, Lemaitre L, Grenier N. Valeur ajoutée de l’IRM de prostate avant première série de biopsies : étude MRI-FIRST. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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103
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Fontenil A, Bigot P, Bernhard JC, Beauval J, Larré S, Charles T, Salomon L, Papare P, Nouhaud FX, Patard J, Baumert H, Lang H, Long J, Villiers A, Henon F, Mejean A, Bensalah K, Soulié M. Mortalité postopératoire dans les trente premiers jours après néphrectomie pour cancer : étude des caractéristiques des patients décédés et des causes de décès. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Nouhaud F, Bernhard JC, Bigot P, Khene Z, Audenet F, Lang H, Bergerat S, Fromont G, Allory Y, Lindner V, Verkarre V, Daniel L, Méjean A, Rioux-Leclercq N, Bensalah K. Profils histologiques des tumeurs rénales kystiques et leur corrélation avec la classification de Bosniak : étude multicentrique Uro-CCR/CCAFU. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Dale M, Fitzgerald MP, Liu Z, Meisinger T, Karpisek A, Purcell LN, Carson JS, Harding P, Lang H, Koutakis P, Batra R, Mietus CJ, Casale G, Pipinos I, Baxter BT, Xiong W. Premature aortic smooth muscle cell differentiation contributes to matrix dysregulation in Marfan Syndrome. PLoS One 2017; 12:e0186603. [PMID: 29040313 PMCID: PMC5645122 DOI: 10.1371/journal.pone.0186603] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 10/04/2017] [Indexed: 12/14/2022] Open
Abstract
Thoracic aortic aneurysm and dissection are life-threatening complications of Marfan syndrome (MFS). Studies of human and mouse aortic samples from late stage MFS demonstrate increased TGF-β activation/signaling and diffuse matrix changes. However, the role of the aortic smooth muscle cell (SMC) phenotype in early aneurysm formation in MFS has yet to be fully elucidated. As our objective, we investigated whether an altered aortic SMC phenotype plays a role in aneurysm formation in MFS. We describe previously unrecognized concordant findings in the aortas of a murine model of MFS, mgR, during a critical and dynamic phase of early development. Using Western blot, gelatin zymography, and histological analysis, we demonstrated that at postnatal day (PD) 7, before aortic TGF-β levels are increased, there is elastic fiber fragmentation/disorganization and increased levels of MMP-2 and MMP-9. Compared to wild type (WT) littermates, aortic SMCs in mgR mice express higher levels of contractile proteins suggesting a switch to a more mature contractile phenotype. In addition, tropoelastin levels are decreased in mgR mice, a finding consistent with a premature switch to a contractile phenotype. Proliferation assays indicate a decrease in the proliferation rate of mgR cultured SMCs compared to WT SMCs. KLF4, a regulator of smooth muscle cell phenotype, was decreased in aortic tissue of mgR mice. Finally, overexpression of KLF4 partially reversed this phenotypic change in the Marfan SMCs. This study indicates that an early phenotypic switch appears to be associated with initiation of important metabolic changes in SMCs that contribute to subsequent pathology in MFS.
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Renard-Penna R, Sanchez-Salas R, Barret E, Cosset JM, de Vergie S, Sapetti J, Ingels A, Gangi A, Lang H, Cathelineau X. [Evaluation and results of ablative therapies in prostate cancer]. Prog Urol 2017; 27:887-908. [PMID: 28939336 DOI: 10.1016/j.purol.2017.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 08/04/2017] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To perform a state of the art about methods of evaluation and present results in ablative therapies for localized prostate cancer. METHODS A review of the scientific literature was performed in Medline database (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) using different associations of keywords. Publications obtained were selected based on methodology, language and relevance. After selection, 102 articles were analysed. RESULTS Analyse the results of ablative therapies is presently difficult considering the heterogeneity of indications, techniques and follow-up. However, results from the most recent and homogeneous studies are encouraging. Oncologically, postoperative biopsies (the most important criteria) are negative (without any tumor cells in the treated area) in 75 to 95%. Functionally, urinary and sexual pre-operative status is spared (or recovered early) in more than 90% of the patients treated. More and more studies underline also the correlation between the results and the technique used considering the volume of the gland and, moreover, the "index lesion" localization. CONCLUSION The post-treatment pathological evaluation by biopsies (targeted with MRI or, perhaps in a near future, with innovative ultrasonography) is the corner stone of oncological evaluation of ablative therapies. Ongoing trials will allow to standardize the follow-up and determine the best indication and the best techniques in order to optimize oncological and functional results for each patient treated.
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Garnon J, Tricard T, Cazzato RL, Cathelineau X, Gangi A, Lang H. [Percutaneous renal ablation: Pre-, per-, post-interventional evaluation modalities and adapted management]. Prog Urol 2017; 27:971-993. [PMID: 28942001 DOI: 10.1016/j.purol.2017.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 08/20/2017] [Accepted: 08/23/2017] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Ablative treatment (AT) rise is foreseen, validation of steps to insure good proceedings is needed. By looking over the process of the patient, this study evaluates the requirements and choices needed in every step of the management. METHODS We searched MEDLINE®, Embase®, using (MeSH) words and we looked for all the studies. Investigators graded the strength of evidence in terms of methodology, language and relevance. RESULTS Explanations of AT proposal rather than partial nephrectomy or surveillance have to be discussed in a consultation shared by urologist and interventional radiologist. Per-procedure choices depend on predictable ballistic difficulties. High volume, proximity of the hilum or of a risky organ are in favor of general anesthesia, cryotherapy and computed tomography/magnetic resonance imaging (CT/MRI). Percutaneous approach should be privileged, as it seems as effective as the laparoscopic approach. Early and delayed complications have to be treated both by urologist and radiologist. Surveillance by CT/MRI insure of the lack of contrast-enhanced in the treated area. Patients and tumors criteria, in case of incomplete treatment or recurrence, are the key of the appropriate treatment: surgery, second session of AT, surveillance. CONCLUSION AT treatments require patient's comprehension, excellent coordination of the partnership between urologist and radiologist and relevant choices during intervention.
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Barret E, Sanchez-Salas R, Galiano M, Cathala N, Mombet A, Prapotnich D, Rozet F, Gangi A, Lang H, Cathelineau X. [Management of ablative therapies in prostate cancer]. Prog Urol 2017; 27:909-925. [PMID: 28918872 DOI: 10.1016/j.purol.2017.07.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 07/20/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To describe the specific modalities of ablative therapies management in prostate cancer. MATERIALS AND METHODS A review of the scientific literature was performed in Medline database (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) using different associations of keywords. Publications obtained were selected based on methodology, language and relevance. After selection, 61 articles were analysed. RESULTS Development of innovations such as ablative therapies in prostate cancer induces specific modalities in their management, during pre-, per- and post-procedure. More than for classical and well-known treatments, the decision to propose an ablative therapy requires analysis and consensus of medical staff and patient's agreement. Patient's specificities and economical aspects must also be considered. Procedures and follow-up must be realized by referents actors. CONCLUSION Indication, procedure and follow-up of ablative therapies in prostate cancer require specific modalities. They must be respected in order to optimize the results and to obtain a precise and objective evaluation for defining future indications.
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Ehlert T, Tug S, Brahmer A, Neef V, Heid F, Werner C, Jansen-Winkeln B, Kneist W, Lang H, Gockel I, Simon P. Establishing PNB-qPCR for quantifying minimal ctDNA concentrations during tumour resection. Sci Rep 2017; 7:8876. [PMID: 28827745 PMCID: PMC5566323 DOI: 10.1038/s41598-017-09137-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 07/20/2017] [Indexed: 12/15/2022] Open
Abstract
The analysis of blood plasma or serum as a non-invasive alternative to tissue biopsies is a much-pursued goal in cancer research. Various methods and approaches have been presented to determine a patient’s tumour status, chances of survival, and response to therapy from serum or plasma samples. We established PNB-qPCR (Pooled, Nested, WT-Blocking qPCR), a highly specific nested qPCR with various modifications to detect and quantify minute amounts of circulating tumour DNA (ctDNA) from very limited blood plasma samples. PNB-qPCR is a nested qPCR technique combining ARMS primers, blocking primers, LNA probes, and pooling of multiple first round products for sensitive quantification of the seven most frequent point mutations in KRAS exon 2. Using this approach, we were able to characterize ctDNA and total cell-free DNA (cfDNA) kinetics by selective amplification of KRAS mutated DNA fragments in the blood plasma over the course of tumour resection and the surrounding days. Whereas total cfDNA concentrations increased over the surgical and regenerative process, ctDNA levels showed a different scheme, rising only directly after tumour resection and about three days after the surgery. For the first time, we present insights into the impact of surgery on the release of ctDNA and total cfDNA.
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Keller M, Darko S, Hanley P, Hoover J, Roesch L, Lang H, McCormack S, Williams E, Manka C, Barese C, Abraham A, Williams K, Jacobsohn D, Perez-Albuerne E, Davila B, Ransier A, Douek D, Bollard C. Adoptive t cell immunotherapy restores targeted antiviral immunity in immunodeficient patients. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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111
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Niebisch S, Hadzijusufovic E, Mehdorn M, Müller M, Scheuermann U, Lyros O, Schulz HG, Jansen-Winkeln B, Lang H, Gockel I. Achalasia-an unnecessary long way to diagnosis. Dis Esophagus 2017; 30:1-6. [PMID: 28375437 DOI: 10.1093/dote/dow004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 10/17/2016] [Indexed: 02/06/2023]
Abstract
Although achalasia presents with typical symptoms such as dysphagia, regurgitation, weight loss, and atypical chest pain, the time until first diagnosis often takes years and is frustrating for patients and nevertheless associated with high costs for the healthcare system. A total of 563 patients were interviewed with confirmed diagnosis of achalasia regarding their symptoms leading to diagnosis along with past clinical examinations and treatments. Included were patients who had undergone their medical investigations in Germany. Overall, 527 study subjects were included (male 46%, female 54%, mean age at time of interview 51 ± 14.8 years). Dysphagia was present in 86.7%, regurgitation in 82.9%, atypical chest pain in 79%, and weight loss in 58% of patients before diagnosis. On average, it took 25 months (Interquartile Range (IQR) 9-65) until confirmation of correct diagnosis of achalasia. Though, diagnosis was confirmed significantly quicker (35 months IQR 9-89 vs. 20 months IQR 8-53; p < 0.01) in the past 15 years. The majority (72.1%) was transferred to three or more specialists. Almost each patient underwent at least one esophagogastroduodenoscopy (94.2%) and one radiological assessment (89.3%). However, esophageal manometry was performed in 70.4% of patients only. The severity of symptoms was independent with regard to duration until first diagnosis (Eckardt score 7.14 ± 2.64 within 12 months vs. 7.29 ± 2.61 longer than 12 months; P = 0.544). Fifty-five percent of the patients primarily underwent endoscopic dilatation and 37% a surgical myotomy. Endoscopic dilatation was realized significantly faster compared to esophageal myotomy (1 month IQR 0-4 vs. 3 months IQR 1-11; p < 0.001). Although diagnosis of achalasia was significantly faster in the past 15 years, it still takes almost 2 years until the correct diagnosis of achalasia is confirmed. Alarming is the fact that although esophageal manometry is known as the gold standard to differentiate primary motility disorders, only three out of four patients had undergone this diagnostic pathway during their diagnostic work-up. Better education of medical professionals and broader utilization of highly sensitive diagnostic tools, such as high-resolution manometry, are strictly necessary in order to correctly diagnose affected patients and to offer therapy faster.
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Abraham A, Keller M, McLaughlin L, Albihani S, Williams E, Saunders D, Lang H, Roesch L, Hoover J, Barese C, Hanley P, Bollard C. Adoptive transfer of multivirus-specific T cells can rapidly restore virus-specific immunity in patients with sickle cell disease undergoing hematopoietic stem cell transplantation. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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113
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Paschold M, Huber T, Maedge S, Zeissig SR, Lang H, Kneist W. Laparoscopic assistance by operating room nurses: Results of a virtual-reality study. NURSE EDUCATION TODAY 2017; 51:68-72. [PMID: 28131934 DOI: 10.1016/j.nedt.2017.01.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 01/03/2017] [Accepted: 01/16/2017] [Indexed: 05/23/2023]
Abstract
BACKGROUND Laparoscopic assistance is often entrusted to a less experienced resident, medical student, or operating room nurse. Data regarding laparoscopic training for operating room nurses are not available. OBJECTIVES The aim of the study was to analyse the initial performance level and learning curves of operating room nurses in basic laparoscopic surgery compared with medical students and surgical residents to determine their ability to assist with this type of procedure. DESIGN The study was designed to compare the initial virtual reality performance level and learning curves of user groups to analyse competence in laparoscopic assistance. PARTICIPANTS The study subjects were operating room nurses, medical students, and first year residents. METHODS Participants performed three validated tasks (camera navigation, peg transfer, fine dissection) on a virtual reality laparoscopic simulator three times in 3 consecutive days. Laparoscopic experts were enrolled as a control group. Participants filled out questionnaires before and after the course. RESULTS Nurses and students were comparable in their initial performance (p>0.05). Residents performed better in camera navigation than students and nurses and reached the expert level for this task. Residents, students, and nurses had comparable bimanual skills throughout the study; while, experts performed significantly better in bimanual manoeuvres at all times (p<0.05). CONCLUSION The included user groups had comparable skills for bimanual tasks. Residents with limited experience reached the expert level in camera navigation. With training, nurses, students, and first year residents are equally capable of assisting in basic laparoscopic procedures.
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Rouviere O, Puech P, Renard Penna R, Claudon M, Roy C, Mege Lechevallier F, Decaussin-Petrucci M, Rabilloud M, Schott Pethelaz A, Dubreuil Chambardel M, Magaud L, Cros F, Barry Delongchamps N, Boutier R, Bratan F, Brunelle S, Camparo P, Colin P, Correas J, Cornélis F, Cornud F, Descotes J, Eschwege P, Fiard G, Fendler J, Habchi H, Hallouin P, Khairoune A, Lang H, Lebras Y, Malavaud B, Moldovan P, Mottet N, Mozer P, Nevoux P, Pagnoux G, Pasticier G, Portalez D, Potiron E, Timsit MO, Villers A, Walz J, Colombel M, Ruffion A, Crouzet S, Lemaitre L, Grenier N. Added value of pre-biopsy prostate multiparametric MRI in biopsy-naïve patients: Preliminary results of the MRI-FIRST trial. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/s1569-9056(17)30558-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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115
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Williams KM, Grant M, Ismail M, Hoq F, Manso MM, Hoover J, Mintz EK, Namata A, Williams E, Barese C, Albihani S, Cruz R, Lang H, Hanley PJ, Gottschalk S, McCurdy SR, Jones RJ, Bollard CM. Infusion of Donor Lymphocytes Specifically Directed to Multiple Tumor Antigens for the Treatment of High Risk Patients after HCT. Biol Blood Marrow Transplant 2017. [DOI: 10.1016/j.bbmt.2016.12.093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Huber T, Paschold M, Bartsch F, Lang H, Kneist W. [Appendectomy in surgical residency. What has changed over the past 10 years?]. Chirurg 2017; 87:326-31. [PMID: 26661947 DOI: 10.1007/s00104-015-0122-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Surgical residents need to train laparoscopic skills for minimally invasive procedures at an early stage. The aim of this study was the investigation and assessment of appendectomy carried out at a university medical center over the previous decade regarding the frequency of operations by residents in training and the type of surgical technique used (laparoscopic vs. open). METHODS A retrospective analysis of appendectomies carried out from 2005 to 2014 at the clinic for general, visceral and transplant surgery was performed. Operators were stratified into two groups (group 1: residents and group 2: fellows/attending surgeons). Surgery was classified as laparoscopic or open appendectomy. RESULTS Out of 1,587 appendectomies analyzed 946 were performed laparoscopically (59.6 %). The percentage of laparoscopic appendectomies increased significantly over the decade analyzed (p < 0.001) and reached 94.4 % in 2014. From 2005 until 2007 the rate of appendectomies by residents was 17.9 % (77 out of 430). Laparoscopic appendectomy was performed in 5.8 % and was only performed by fellows or attending surgeons. From 2008 to 2014 the rate of surgeries by residents significantly increased (p < 0.001) and accounted for 57.6 % (range 19.4-66.9 %). CONCLUSION Regardless of the surgical technique used, appendectomy is still a primary training operation for surgical residents. An early and focused training of minimally invasive visceral surgery in the new regulations for continuing medical education starts with laparoscopic appendectomy.
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Lock J, Vondran F, Settmacher U, Tautenhahn H, Lang H, Pratschke J, Germer C, Klein I, Stockmann M. A new effective enhanced recovery pathway after liver surgery using the LiMAx test − results from a multicenter prospective randomized controlled trial. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30294-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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118
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Preda AM, Schneider WB, Schaarschmidt D, Lang H, Mertens L, Auer AA, Mehring M. The role of dispersion type metal⋯π interaction in the enantiotropic phase transition of two polymorphs of tris-(thienyl)bismuthine. Dalton Trans 2017; 46:13492-13501. [PMID: 28951920 DOI: 10.1039/c7dt02567j] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Bi(2-C4H3S)3 shows an enantiotropic phase transition that is dominated by London dispersion forces. DFT calculations on model compounds were carried out in order to investigate the competition between Bi⋯S and Bi⋯π heteroarene interaction.
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Bartsch F, Huber T, Lang H. [Extended Left Hemihepatectomy with Reconstruction of The Right Liver Vein in a Patient with an Intrahepatic Cholangiocellular Carcinoma]. Zentralbl Chir 2016; 141:604-606. [PMID: 27960221 DOI: 10.1055/s-0042-117283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Extended left hemihepatectomy (left trisectionectomy) with resection of liver segments 1, 2, 3, 4 a/b, 5 and 8 is a challenging procedure. In well-selected patients, the indication for this procedure may offer the chance of curative resection for primary or secondary liver tumours in complicated locations. Morbidity and mortality are increased compared to non-extended liver resections. This procedure requires precise imaging and accurate surgical planning in due consideration of the remaining liver volume and additional factors such as preliminary damage of the liver parenchyma caused by chemotherapy or fibrosis/cirrhosis. Left trisectionectomy is necessary in tumours affecting either the middle and left hepatic vein or the blood vessels of the liver hilum to the left and middle liver sector. The procedure necessitates the preservation of the right hepatic vein and the portal-venous and arterial branches supplying segments 6 and 7, as well as the bile ducts of these segments. This video article illustrates the surgical procedure of extended left hemihepatectomy performed due to an intrahepatic cholangiocellular carcinoma, which centrally surrounds the left and middle hepatic vein and potentially infiltrates the right hepatic vein. This condition requires the tangential resection and reconstruction of the right hepatic vein.
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Lang H, Korkmaz Y, Schneider K, Raab WHM. Impact of Endodontic Treatments on the Rigidity of the Root. J Dent Res 2016; 85:364-8. [PMID: 16567560 DOI: 10.1177/154405910608500416] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The destabilizing effect of endodontic treatment upon teeth is still controversial. The purpose of this study was to investigate the effects of different steps of endodontic treatments upon the rigidity of teeth. Extracted untreated central maxillary anterior teeth were loaded (3.75 N), and deformations of the root were assessed by Speckle pattern interferometry. The following treatments (with subsequent determination of deformability) were conducted sequentially: access preparation, manual instrumentation (Kerr files ISO-40, ISO-60, ISO-80, ISO-110), and tapered and parallel-sided post preparation. It was found that the teeth were increasingly destabilized by any treatment. While the increased deformability was not significant with the manual enlargement (p > 0.05), we found a significant destabilization after access preparation and post preparation (p < 0.05). A corresponding difference was found after conversion of the post preparation from tapered to parallel-sided (p < 0.05). Both substance loss and modifications of the natural root canal geometry play an important role in tooth rigidity.
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Neumann U, Denecke T, Pratschke J, Lang H, Bemelmans M, Becker T, Rentsch M, Seehofer D, Bruns C, Gebauer B, Folprecht G, Stintzing S, Held S, Heinemann V, Modest D. Evaluation for surgical treatment options in metastatic colorectal cancer (mCRC) – a retrospective, central evaluation of FIRE-3. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ohana M, Lindner V, Labani A, Alemann G, Lang H, Roy C. Fibrous Pseudotumor of the Tunica Vaginalis of the Scrotum: Is there a Typical Ultrasound Pattern? Ultrasound Int Open 2016; 2:E34-6. [PMID: 27689166 DOI: 10.1055/s-0035-1569412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Watzka FM, Fottner C, Miederer M, Weber MM, Schad A, Lang H, Musholt TJ. Surgical Treatment of NEN of Small Bowel: A Retrospective Analysis. World J Surg 2016; 40:749-58. [PMID: 26822157 DOI: 10.1007/s00268-016-3432-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Neuroendocrine Neoplasms of the small intestine have been noticed more frequently over the past 35 years. They constitute about 25% of all NENs and 29% of all tumors of the small intestine. Due to the predominantly indolent nature and overall good prognosis, the benefit of surgical treatment is still debated. METHODS In a retrospective study, data of 83 surgically treated patients with neuroendocrine neoplasms of the small intestine, 48 males and 35 females with a median age of 62 years (range 25-86 years) were analyzed. Patient data were documented in the MaDoc database for neuroendocrine tumors of the University Medical Center of Mainz. IBM SPSS Statistics 20 was used for statistical analysis. Kaplan-Meier survival curves and Log-Rank tests, censoring patients at the time of last follow-up, were used to compare the overall survival depending on potential prognostic factors (stage, grade, surgical treatment). RESULTS At the time of diagnoses, the most common clinical symptoms were abdominal pain (n = 31, 37.3%), bowel obstruction (n = 11, 13.3%), bowel perforation and peritonitis (n = 3, 3.6%), gastrointestinal bleeding (n = 9, 10.8%), weight loss (n = 11, 13.3%), and carcinoid syndrome (n = 27, 32.5%). 65 patients (78.3%) had lymph node metastasis and in 58 patients (69.9%) distant metastasis were present. Segmental bowel resection (44) was the most common surgical procedure, followed by right hemi-colectomy (32) and explorative laparotomy (7). In most patients (78.9%), lymphadenectomy (systematic/selective) was performed. The 5-year survival of patients who underwent a systematic or a selective lymphadenectomy differed significantly (82.2 vs. 40.0%). The overall 3-, 5-, and 10-year survival rates were 88.2, 80.3, and 71.0%, respectively. CONCLUSION Mesenteric lymph node metastases are almost invariably present and have significant impact on patients' prognosis. Systematic lymphadenectomy prevents complications and improves the survival. Early surgical treatment should be the goal in order to prevent complications.
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Huber T, Bartsch F, Lang H. [Technique of Mesohepatectomy]. Zentralbl Chir 2016; 141:365-7. [PMID: 27556427 DOI: 10.1055/s-0042-105297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
In patients with primary or secondary malignant central liver tumours, the standard surgical procedure is extended left or right hemihepatectomy. Since extended resections are associated with increased morbidity and mortality and a loss of a large amount of functional liver parenchyma, central liver resection or mesohepatectomy (resection of segments 4a/4b, 5 and 8) with or without the resection of segment 1 is an alternative procedure, although technically demanding and not widely used so far. Resection margins are to the right of the falciform ligament and at the border between segments 5/6 and 7/8, which can be difficult to differentiate. Intraoperative sonography is highly recommended. The current video shows the technique of mesohepatectomy under exclusion of segment 1 in a case of a central colorectal liver metastasis.
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Suh M, Dale M, Karpisek A, Carson J, Lang H, Baxter BT, Xiong W. PC220. Premature Aortic Smooth Muscle Cell Differentiation Contributes to Matrix Dysregulation in Marfan Syndrome. J Vasc Surg 2016. [DOI: 10.1016/j.jvs.2016.03.368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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