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Rimbach H, Linxweiler M, Körner S, Smola S, Linxweiler B, Speicher S, Helfrich J, Solomayer EF, Wagner M, Schick B, Kühn JP. Prediction of lymph node status in patients with surgically treated head and neck squamous cell carcinoma via neck lavage cytology: A pilot study. Cancer Cytopathol 2024. [PMID: 38329321 DOI: 10.1002/cncy.22800] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/09/2023] [Accepted: 12/11/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND Neck dissection is a standardized surgical procedure for patients with head and neck squamous cell carcinoma (HNSCC) and plays a critical role in the choice of adjuvant treatment based on histopathological findings. Saline irrigation is routinely performed at the end of surgery. However, this irrigant is not used for diagnostic purposes. METHODS Intraoperative irrigation of the neck dissection wound was performed in 56 patients with HNSCC (N = 93 neck dissections), and the cytological suspension obtained was processed via the liquid-based cytology (LBC) technique, Papanicolaou staining, and immunocytochemical staining. Microscopic preparations were screened for the presence of tumor cells and classified as positive, borderline, or negative. These results were correlated with the histopathological and clinical data. RESULTS Neck lavage LBC demonstrated high diagnostic value in detecting lymph node metastases (N+) with extracapsular spread (ECS), with a specificity, sensitivity, negative predictive value, and positive predictive value of 93.1%, 100%, 100%, and 80%, respectively. Tumor cells were detected in 4.8% of N- cases, 20% of N+ cases without ECS, and 100% of N+ cases with ECS. Receiver operating characteristic curve analysis showed an area under the curve of 0.8429 for the prediction of N+ (p < .0001) and 0.9658 for the prediction of N+ with ECS (p < .0001). CONCLUSIONS Differential lavage cytology can provide valid and rapid information on the lymph node status in patients with HNSCC and showed an excellent correlation with histopathology. Thus, neck lavage LBC may facilitate faster and more reasonable planning of adjuvant treatment and help improve the therapeutic management of patients with HNSCC.
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Affiliation(s)
- Hugo Rimbach
- Department of Otorhinolaryngology, Saarland University, Homburg/Saar, Germany
| | | | - Sandrina Körner
- Department of Otorhinolaryngology, Saarland University, Homburg/Saar, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University, Homburg/Saar, Germany
| | | | - Stefanie Speicher
- Department of Otorhinolaryngology, Saarland University, Homburg/Saar, Germany
| | - Johanna Helfrich
- Department of Otorhinolaryngology, Saarland University, Homburg/Saar, Germany
| | | | - Mathias Wagner
- Department of Pathology, Saarland University, Homburg/Saar, Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Saarland University, Homburg/Saar, Germany
| | - Jan Philipp Kühn
- Department of Otorhinolaryngology, Saarland University, Homburg/Saar, Germany
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Kühn JP, Speicher S, Linxweiler B, Körner S, Rimbach H, Wagner M, Solomayer EF, Schick B, Linxweiler M. Dual Sec62/Ki67 immunocytochemistry of liquid-based cytological preparations represents a highly valid biomarker for non-invasive detection of head and neck squamous cell carcinomas. Cytopathology 2024; 35:113-121. [PMID: 37787092 DOI: 10.1111/cyt.13310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND Head and neck squamous cell carcinomas (HNSCC) are frequently diagnosed in advanced stages, which limits therapeutic options and results in persistently poor patient outcomes. The aim of this study was to use liquid-based swab cytology (LBC) in combination with dual immunocytochemical detection of migration and proliferation markers Sec62 and Ki67 in order to allow non-invasive early detection of HNSCC as well as to analyse the diagnostic validity of this method for predicting the malignancy of suspicious oral lesions. METHODS 104 HNSCC patients and 28 control patients, including healthy patients (n = 17), papilloma (n = 1) and leukoplakia patients (n = 10), were included in this study. For all patients, an LBC swab followed by simultaneous immunocytochemical detection of Sec62 and Ki67 was performed. Immunocytochemical as well as cytopathological results were correlated with histological diagnoses and clinical findings. RESULTS All HNSCC patients (100%) showed dual Sec62/Ki67 positivity, and all control patients except for the papilloma patient were negative for Sec62/Ki67 (96.4%), resulting in a 100% sensitivity and 96.4% specificity of Sec62/Ki67 dual stain for non-invasive detection of HNSCC. The positive predictive value was 99% and the negative predictive value was 100%. Sec62 expression levels showed a positive correlation with tumour de-differentiation (p = 0.0489). CONCLUSION Simultaneous immunocytochemical detection of Sec62/Ki67 using LBC represents a promising non-invasive and easy-to-apply tool for the early detection of HNSCC in routine clinical practice. This novel technique can help to avoid incisional biopsies and reduce the frequency with which general anaesthesia is used in diagnostic procedures in patients with suspicious oral lesions.
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Affiliation(s)
- Jan Philipp Kühn
- Department of Otorhinolaryngology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Stefanie Speicher
- Department of Otorhinolaryngology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Barbara Linxweiler
- Department of Gynecology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Sandrina Körner
- Department of Otorhinolaryngology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Hugo Rimbach
- Department of Otorhinolaryngology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Mathias Wagner
- Department of Pathology, Saarland University Medical Center, Homburg/Saar, Germany
| | | | - Bernhard Schick
- Department of Otorhinolaryngology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Maximilian Linxweiler
- Department of Otorhinolaryngology, Saarland University Medical Center, Homburg/Saar, Germany
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Linxweiler M, Schneider M, Körner S, Knebel M, Brust LA, Braun FL, Wemmert S, Wagner M, Hecht M, Schick B, Kühn JP. Expression of 3q Oncogene SEC62 Predicts Survival in Head and Neck Squamous Cell Carcinoma Patients Treated with Primary Chemoradiation. Cancers (Basel) 2023; 16:98. [PMID: 38201525 PMCID: PMC10778380 DOI: 10.3390/cancers16010098] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/19/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
Primary chemoradiotherapy (CRT) is an established treatment option for locally advanced head and neck squamous cell carcinomas (HNSCC) usually combining intensity modified radiotherapy with concurrent platinum-based chemotherapy. Though the majority of patients can be cured with this regimen, treatment response is highly heterogeneous and can hardly be predicted. SEC62 represents a metastasis stimulating oncogene that is frequently overexpressed in various cancer entities and is associated with poor outcome. Its role in HNSCC patients undergoing CRT has not been investigated so far. A total of 127 HNSCC patients treated with primary CRT were included in this study. The median follow-up was 5.4 years. Pretherapeutic tissue samples of the primary tumors were used for immunohistochemistry targeting SEC62. SEC62 expression, clinical and histopathological parameters, as well as patient outcome, were correlated in univariate and multivariate survival analyses. High SEC62 expression correlated with a significantly shorter overall survival (p = 0.015) and advanced lymph node metastases (p = 0.024). Further significant predictors of poor overall and progression-free survival included response to therapy (RECIST1.1), nodal status, distant metastases, tobacco consumption, recurrence of disease, and UICC stage. In a multivariate Cox hazard proportional regression analysis, only SEC62 expression (p = 0.046) and response to therapy (p < 0.0001) maintained statistical significance as independent predictors of the patients' overall survival. This study identified SEC62 as an independent prognostic biomarker in HNSCC patients treated with primary CRT. The role of SEC62 as a potential therapeutic target and its interaction with radiation-induced molecular alterations in head and neck cancer cells should further be investigated.
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Affiliation(s)
- Maximilian Linxweiler
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, D-66421 Homburg, Germany; (M.S.); (S.K.); (M.K.); (L.A.B.); (S.W.); (B.S.); (J.P.K.)
| | - Matthias Schneider
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, D-66421 Homburg, Germany; (M.S.); (S.K.); (M.K.); (L.A.B.); (S.W.); (B.S.); (J.P.K.)
| | - Sandrina Körner
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, D-66421 Homburg, Germany; (M.S.); (S.K.); (M.K.); (L.A.B.); (S.W.); (B.S.); (J.P.K.)
| | - Moritz Knebel
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, D-66421 Homburg, Germany; (M.S.); (S.K.); (M.K.); (L.A.B.); (S.W.); (B.S.); (J.P.K.)
| | - Lukas Alexander Brust
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, D-66421 Homburg, Germany; (M.S.); (S.K.); (M.K.); (L.A.B.); (S.W.); (B.S.); (J.P.K.)
| | - Felix Leon Braun
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, D-66421 Homburg, Germany; (M.S.); (S.K.); (M.K.); (L.A.B.); (S.W.); (B.S.); (J.P.K.)
| | - Silke Wemmert
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, D-66421 Homburg, Germany; (M.S.); (S.K.); (M.K.); (L.A.B.); (S.W.); (B.S.); (J.P.K.)
| | - Mathias Wagner
- Department of General and Surgical Pathology, Saarland University Medical Center, D-66421 Homburg, Germany;
| | - Markus Hecht
- Department of Radiotherapy and Radiation Oncology, Saarland University Medical Center, D-66421 Homburg, Germany;
| | - Bernhard Schick
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, D-66421 Homburg, Germany; (M.S.); (S.K.); (M.K.); (L.A.B.); (S.W.); (B.S.); (J.P.K.)
| | - Jan Philipp Kühn
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, D-66421 Homburg, Germany; (M.S.); (S.K.); (M.K.); (L.A.B.); (S.W.); (B.S.); (J.P.K.)
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Trennheuser S, Reith W, Kühn JP, Morris LGT, Bozzato A, Naumann A, Schick B, Yilmaz U, Linxweiler M. Transorbital embolization of cavernous sinus dural arterio-venous malformations with surgical exposure and catheterization of the superior ophthalmic vein. Interv Neuroradiol 2023; 29:715-724. [PMID: 35758285 PMCID: PMC10680959 DOI: 10.1177/15910199221110967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/11/2022] [Accepted: 06/14/2022] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Cavernous sinus dural arterio-venous malformations (dAVF) represent a pathologic connection between branches of the internal and/or external carotid artery and the cavernous sinus. Standard endovascular approaches for dAVF treatment are transvenous embolization through the inferior petrosal sinus or the facial vein and transarterial embolization. These approaches are not always successful or feasible, and alternative techniques are required. Here, we present a case series of a minimally invasive transorbital approach with surgical exposure and catheterization of the superior ophthalmic vein for transvenous fistula coiling. METHODS 14 patients with dAVFs (Barrow Type B to D) that were treated at a tertiary care medical center over a period of 13 years were included in the study. Patients with persisting dAVF associated symptoms were selected for this approach when conventional endovascular interventions were not successful or not feasible. The surgical procedure was performed under general anaesthesia. RESULTS A successful transorbital approach was performed in all 14 cases. In 12 of 14 patients a catheter assisted successful embolization of the fistula was performed using platinum coils with no relevant residual fistula flow. In two cases, a spontaneous thrombosis of the fistula during the surgical procedure required no further embolization. No postoperative therapy-associated complications were observed. CONCLUSION The described approach is an effective method to embolize dAVFs in selected cases when catheter assisted transvenous and/or transarterial embolization is not successful or not feasible. In this case series we demonstrate an excellent success rate with no therapy-associated major complications.
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Affiliation(s)
- Sophie Trennheuser
- Department of Otorhinolaryngology, Head and Neck Surgery; Saarland University Medical Center, Homburg/Saar, Germany
| | - Wolfgang Reith
- Department of Diagnostic and Interventional Neuroradiology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Jan Philipp Kühn
- Department of Otorhinolaryngology, Head and Neck Surgery; Saarland University Medical Center, Homburg/Saar, Germany
| | - Luc G T Morris
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | - Alessandro Bozzato
- Department of Otorhinolaryngology, Head and Neck Surgery; Saarland University Medical Center, Homburg/Saar, Germany
| | - Andreas Naumann
- Department of Otorhinolaryngology, plastic surgery and special pain therapy, Bremen Mitte Hospital, Bremen, Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Head and Neck Surgery; Saarland University Medical Center, Homburg/Saar, Germany
| | - Umut Yilmaz
- Department of Diagnostic and Interventional Neuroradiology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Maximilian Linxweiler
- Department of Otorhinolaryngology, Head and Neck Surgery; Saarland University Medical Center, Homburg/Saar, Germany
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Flockerzi V, Schick B, Bozzato A. [Experiences with endoscopic ear surgery of a German tertiary hospital for otolaryngology]. HNO 2023; 71:787-794. [PMID: 37599311 PMCID: PMC10663200 DOI: 10.1007/s00106-023-01348-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND The aim of this article is to report on the integration of endoscopic ear surgery (EES) into daily clinical practice. MATERIAL AND METHODS In a monocentric prospective study, the endoscopy unit was set up during even weeks over a period of 10 months and the procedure was primarily started endoscopically via a transmeatal approach. In odd weeks, the endoscopy was omitted. A total of 60 procedures in 59 patients were evaluated. Points of comparison were intraoperative vision, incision-suture time, postoperative hearing outcome, and postoperative otoscopic findings. RESULTS With the exception of the facial nerve (p = 0.15 Mann-Whitney U‑test), the EES showed significantly improved visualization of all areas in the middle ear. The incision-suture times were similar in both methods. If bimanual placement of an ossicular prosthesis was necessary, the incision-suture time increased disproportionately (MES: 57.18 ± 9.7 min, EES: 76.83 ± 24.99 min; p = 0.019, *). There were no statistically significant changes related to hearing outcomes when comparing EES with the microscopic technique. There were no postoperative complications in the EES surgery group. CONCLUSION Integration of EES proved to be successful and advantageous in a real patient collective at this location.
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Affiliation(s)
- Veronika Flockerzi
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes, 66421, Homburg, Deutschland.
| | - Bernhard Schick
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes, 66421, Homburg, Deutschland
| | - Alessandro Bozzato
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes, 66421, Homburg, Deutschland
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Sivakumar BS, Thatcher K, Hughes I, Watson A, Schick B, Graham DJ. Comparison of Arterial and Venous Interposition Grafting for Arterial Defects in a Rat Model. J Reconstr Microsurg 2023. [PMID: 38011855 DOI: 10.1055/s-0043-1776735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
BACKGROUND Interposition microvascular grafting may be required to bridge arterial defects during digital replantation or revascularization and has traditionally been performed utilizing a venous autograft. Arterial interposition grafting has been shown to be superior in maintaining patency in large vessel surgery; there are case reports of its use in microsurgery. METHODS Six fellowship-trained hand and microsurgeons performed arterial and venous interposition grafts on the femoral arteries of 40 Wistar rats. After sectioning one femoral artery a segment of the contralateral femoral artery or vein was obtained. The time was recorded per graft and patency tested 10 minutes following grafting by an independent assessor. Each surgeon also completed a questionnaire detailing regular microsurgical volume, technical ease, and conceptual preference for either graft. RESULTS Time for arterial interposition (median time 51.7 minutes) was longer than venous grafting (median time 45.9 minutes, p = 0.075). Arterial grafts were more likely to be patent or questionably patent (odds ratio [OR] = 6.77, p = 0.031). All surgeons found arterial interposition grafting technically easier and preferred it conceptually. Improvements were noted in patency rates (OR = 11.29, p = 0.018) and avoidance of anastomotic leak (OR = 0.19, p = 0.029) when surgeons performed moderate levels or greater of microsurgery within their regular practice. CONCLUSION Greater immediate patency was noted with arterial interposition grafting in a rodent model when compared to venous grafting, although procedural time was greater. All surgeons found arterial grafting technically easier. Arterial microvascular grafting may be useful in the setting of digital replantation or revascularization with an arterial defect.
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Affiliation(s)
- B S Sivakumar
- Australian Research Collaboration on Hands (ARCH), Mudgeeraba, Australia
- Discipline of Surgery, Sydney Medical School, the Faculty of Medicine and Health, the University of Sydney, Camperdown, NSW, Australia
- Department of Orthopaedic Surgery, Northern Beaches Hospital, Frenchs Forest, NSW, Australia
- Department of Orthopaedic Surgery, Hornsby Ku-ring-gai Hospital, Hornsby, NSW, Australia
- Department of Orthopaedic Surgery, Nepean Hospital, Kingswood, NSW, Australia
| | - K Thatcher
- Department of Hand and Peripheral Nerve Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - I Hughes
- School of Medicine, University of Queensland, Herston, QLD, Australia
- Office for Research Governance and Development, Gold Coast Health, Southport, QLD, Australia
| | - Anna Watson
- Department of Orthopaedic Surgery, Northern Beaches Hospital, Frenchs Forest, NSW, Australia
| | - B Schick
- Department of Hand Surgery, Sydney Hospital, Sydney Hospital Hand Unit, Sydney, NSW, Australia
| | - D J Graham
- Australian Research Collaboration on Hands (ARCH), Mudgeeraba, Australia
- School of Medicine, University of Queensland, Herston, QLD, Australia
- Department of Musculoskeletal Services, Gold Coast University Hospital, Southport, QLD, Australia
- School of Medicine and Dentistry, Griffith University, Southport, QLD, Australia
- Department of Orthopaedic Surgery, Queensland Children's Hospital, South Brisbane, QLD, Australia
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Mohammad L, Fousse M, Wenzel G, Flotats Bastardas M, Faßbender K, Dillmann U, Schick B, Zemlin M, Gärtner BC, Sester U, Schub D, Schmidt T, Sester M. Alterations in pathogen-specific cellular and humoral immunity associated with acute peripheral facial palsy of infectious origin. J Neuroinflammation 2023; 20:246. [PMID: 37880696 PMCID: PMC10598953 DOI: 10.1186/s12974-023-02933-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 10/14/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Peripheral facial palsy (PFP) is a common neurologic symptom which can be triggered by pathogens, autoimmunity, trauma, tumors, cholesteatoma or further local conditions disturbing the peripheral section of the nerve. In general, its cause is often difficult to identify, remaining unknown in over two thirds of cases. As we have previously shown that the quantity and quality of pathogen-specific T cells change during active infections, we hypothesized that such changes may also help to identify the causative pathogen in PFPs of unknown origin. METHODS In this observational study, pathogen-specific T cells were quantified in blood samples of 55 patients with PFP and 23 healthy controls after stimulation with antigens from varicella-zoster virus (VZV), herpes-simplex viruses (HSV) or borrelia. T cells were further characterized by expression of the inhibitory surface molecule CTLA-4, as well as markers for differentiation (CD27) and proliferation (Ki67). Pathogen-specific antibody responses were analyzed using ELISA. Results were compared with conventional diagnostics. RESULTS Patients with PFP were more often HSV-seropositive than controls (p = 0.0003), whereas VZV- and borrelia-specific antibodies did not differ between groups. Although the quantity and general phenotypical characteristics of antigen-specific T cells did not differ either, expression of CTLA-4 and Ki67 was highly increased in VZV-specific T cells of 9 PFP patients, of which 5 showed typical signs of cutaneous zoster. In the remaining 4 patients, a causal relationship with VZV was possible but remained unclear by clinical standard diagnostics. A similar CTLA-4- and Ki67-expression profile of borrelia-specific T cells was also found in a patient with acute neuroborreliosis. DISCUSSION In conclusion, the high prevalence of HSV-seropositivity among PFP-patients may indicate an underestimation of HSV-involvement in PFP, even though HSV-specific T cell characteristics seem insufficient to identify HSV as a causative agent. In contrast, striking alterations in VZV- and borrelia-specific T cell phenotype and function may allow identification of VZV- and borrelia-triggered PFPs. If confirmed in larger studies, antigen-specific immune-phenotyping may have the potential to improve specificity of the clinical diagnosis.
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Affiliation(s)
- Leyla Mohammad
- Department of Transplant and Infection Immunology, Saarland University, 66421, Homburg, Germany
| | - Mathias Fousse
- Department of Neurology, Saarland University, Homburg, Germany
| | - Gentiana Wenzel
- Department of Otorhinolaryngology, Saarland University, Homburg, Germany
| | | | - Klaus Faßbender
- Department of Neurology, Saarland University, Homburg, Germany
| | - Ulrich Dillmann
- Department of Neurology, Saarland University, Homburg, Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Saarland University, Homburg, Germany
| | - Michael Zemlin
- Department of Pediatrics and Neonatology, Saarland University, Homburg, Germany
| | - Barbara C Gärtner
- Department of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | | | - David Schub
- Department of Transplant and Infection Immunology, Saarland University, 66421, Homburg, Germany
| | - Tina Schmidt
- Department of Transplant and Infection Immunology, Saarland University, 66421, Homburg, Germany
| | - Martina Sester
- Department of Transplant and Infection Immunology, Saarland University, 66421, Homburg, Germany.
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Kulas P, Schick B, Helfrich J, Bozzato A, Hecker DJ, Pillong L. Assessing the Use of Telepresence-Guided Video-Based Head and Neck Ultrasound Training: A Step towards Minimizing Dependence on Human Resources? Diagnostics (Basel) 2023; 13:2828. [PMID: 37685366 PMCID: PMC10487032 DOI: 10.3390/diagnostics13172828] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/20/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
The acquisition of ultrasound skills is an essential part of any medical student's education. University access restrictions in the context of the COVID-19 pandemic have highlighted the need for digitization in teaching. However, teaching manual skills in online courses has proven to be challenging, not least in terms of human resources. Therefore, the aim of this study was to set up a hybrid head and neck ultrasound course consisting of a preface of video-based self-study followed by supportive instruction by a tutor in telepresence and to evaluate the quality, effectiveness, and feasibility of this teaching method. Thirty-five students were shown video tutorials on systematic ultrasound of the neck course. Learning outcomes were analyzed using self-assessment questionnaires and external assessment by an experienced ultrasonographer. All participants demonstrated statistically significant learning improvement (p < 0.001) when comparing self-assessment scores before and after training. The mean self-assessment scores increased from 13.8 to 26.6 for the telepresence-guided group, from 16.6 to 27.3 for the web-based group, and from 14.0 to 26.2 for the in-person group. The external observer assessment also showed improvement, with mean scores of 46.7, 48.1, and 46.5, respectively. Overall results did not significantly differ when comparing different instruction modalities. A telepresence-guided video-based ultrasound course is well suited to teaching ultrasound skills similar to in-person courses and allows a more resource-efficient targeting of student needs.
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Affiliation(s)
| | | | | | | | | | - Lukas Pillong
- Department for Otorhinolaryngology and Head- and Neck-Surgery, Saarland University Medical Center, Kirrbergerstraße 100, 66421 Homburg, Germany; (P.K.); (B.S.); (J.H.); (A.B.); (D.J.H.)
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9
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Flockerzi V, Schick B, Bozzato A. Thunder and lightning-a report on firework-associated acoustic trauma at New Year 2021/2022. HNO 2023; 71:44-49. [PMID: 36847786 PMCID: PMC9969936 DOI: 10.1007/s00106-022-01260-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 03/01/2023]
Abstract
BACKGROUND This cross-sectional study aimed to assess the frequency and type of firework-associated acoustic trauma occurring in Germany on New Year's Eve 2021, despite the ban on firework sales due to the COVID-19 pandemic. MATERIALS AND METHODS The survey period lasted 7 days, from 28 December 2021 to 03 January 2022. A questionnaire inquired date, type and treatment of trauma, sex, and age of the patient, and whether the trauma occurred when lighting or watching fireworks. Hearing impairment was classified according to the World Health Organization (WHO grades 0 to 4), and concomitant tinnitus, vertigo, or other injuries were recorded. The questionnaire was sent to the otorhinolaryngology departments of 171 hospitals in Germany. RESULTS Of 37 otorhinolaryngology departments, 16 reported no and 21 reported 50 patients with firework-associated acoustic trauma. Mean age was 29 ± 16 years and 41 of 50 patients were males. Of these 50 patients, 22 presented without and 28 with hearing loss, 32 reported tinnitus and 3 vertigo; 20 patients were injured when lighting fireworks and 30 when watching. Hearing impairment was classified as 14 × WHO grade 0, 5 × WHO grade 1, 4 × WHO grade 2, 2 × WHO grade 3, and 3 × WHO grade 4. Inpatient treatment was received by 8 patients and 11 suffered from concomitant burn injuries. CONCLUSION Despite the sales ban, some firework-associated acoustic traumas occurred at New Year 2021/2022 in Germany. Some instances led to hospitalization, but an even higher number of unreported cases can be assumed. This study can serve as a baseline for further annual surveys to raise the awareness of the danger of seemingly harmless fireworks for the individual.
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Affiliation(s)
- Veronika Flockerzi
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes, 66421, Homburg, Germany.
| | - Bernhard Schick
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes, 66421, Homburg, Germany
| | - Alessandro Bozzato
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes, 66421, Homburg, Germany
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10
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Knebel M, Körner S, Kühn JP, Wemmert S, Brust L, Smola S, Wagner M, Bohle RM, Morris LGT, Pandey A, Schick B, Linxweiler M. Prognostic impact of intra- and peritumoral immune cell subpopulations in head and neck squamous cell carcinomas - comprehensive analysis of the TCGA-HNSC cohort and immunohistochemical validation on 101 patients. Front Immunol 2023; 14:1172768. [PMID: 37383237 PMCID: PMC10294051 DOI: 10.3389/fimmu.2023.1172768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/31/2023] [Indexed: 06/30/2023] Open
Abstract
Background Due to the expanding role of immune checkpoint inhibition in the treatment of head and neck squamous cell carcinoma, understanding immunological processes in the tumor microevironment (TME) has strong translational importance. Though analytical methods for a comprehensive analysis of the immunological TME have constantly improved and expanded over the past years the prognostic relevance of immune cell composition in head and neck cancer TME largely remains ambiguous with most studies focusing on one or a small subset of immune cells. Methods The overall survival (OS) of the TCGA-HNSC patient cohort comprising 513 head and neck cancer patients was correlated with a total of 29 different immune metrics including a wide spectrum of immune cell subpopulations as well as immune checkpoint receptors and cytokines using RNAseq based immune deconvolution analyses. The most significant predictors of survival among these 29 immune metrics were validated on a separate HNSCC patient cohort (n=101) using immunohistochemistry: CD3, CD20+CXCR5, CD4+CXCR5, Foxp3 and CD68. Results Overall immune infiltration irrespective of immune cell composition showed no significant correlation with the patients' overall survival in the TCGA-HNSC cohort. However, when focusing on different immune cell subpopulations, naïve B cells (p=0.0006), follicular T-helper cells (p<0.0001), macrophages (p=0.0042), regulatory T cells (p=0.0306), lymphocytes (p=0.0001), and cytotoxic T cells (p=0.0242) were identified as highly significant predictors of improved patient survival. Using immunohistochemical detection of these immune cells in a second independent validation cohort of 101 HNSCC patients, we confirmed the prognostic relevance of follicular T helper cells, cytotoxic T cells and lymphocytes. In multivariable analysis, HPV negativity and advanced UICC stages were identified as additional prognostic biomarkers associated with poor outcome. Conclusion Our study highlights the prognostic relevance of the immunological tumor environment in head and neck cancer and demonstrates that a more detailed analysis of immune cell composition and immune cell subtypes is necessary to accurately prognosticate. We observed the highest prognostic relevance for lymphocytes, cytotoxic T cells, and follicular T helper cells, suggesting further investigations focusing on these specific immune cell subpopulations not only as predictors of patient prognosis but also as promising targets of new immunotherapeutic strategies.
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Affiliation(s)
- Moritz Knebel
- Department of Otorhinolaryngology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Sandrina Körner
- Department of Otorhinolaryngology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Jan Philipp Kühn
- Department of Otorhinolaryngology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Silke Wemmert
- Department of Otorhinolaryngology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Lukas Brust
- Department of Otorhinolaryngology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Mathias Wagner
- Department of General and Surgical Pathology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Rainer M. Bohle
- Department of General and Surgical Pathology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Luc G. T. Morris
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York City, NY, United States
| | - Abhinav Pandey
- Weill Cornell School of Medical Sciences, New York City, NY, United States
| | - Bernhard Schick
- Department of Otorhinolaryngology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Maximilian Linxweiler
- Department of Otorhinolaryngology, Saarland University Medical Center, Homburg, Saar, Germany
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11
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Englisch CN, Steinhäuser J, Wemmert S, Jung M, Gawlitza J, Wenzel G, Schick B, Tschernig T. Immunohistochemistry Reveals TRPC Channels in the Human Hearing Organ-A Novel CT-Guided Approach to the Cochlea. Int J Mol Sci 2023; 24:ijms24119290. [PMID: 37298241 DOI: 10.3390/ijms24119290] [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: 04/21/2023] [Revised: 05/16/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
TRPC channels are critical players in cochlear hair cells and sensory neurons, as demonstrated in animal experiments. However, evidence for TRPC expression in the human cochlea is still lacking. This reflects the logistic and practical difficulties in obtaining human cochleae. The purpose of this study was to detect TRPC6, TRPC5 and TRPC3 in the human cochlea. Temporal bone pairs were excised from ten body donors, and the inner ear was first assessed based on computed tomography scans. Decalcification was then performed using 20% EDTA solutions. Immunohistochemistry with knockout-tested antibodies followed. The organ of Corti, the stria vascularis, the spiral lamina, spiral ganglion neurons and cochlear nerves were specifically stained. This unique report of TRPC channels in the human cochlea supports the hypothesis of the potentially critical role of TRPC channels in human cochlear health and disease which has been suggested in previous rodent experiments.
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Affiliation(s)
- Colya N Englisch
- Institute of Anatomy and Cell Biology, Saarland University, 66421 Homburg/Saar, Germany
| | - Jakob Steinhäuser
- Institute of Anatomy and Cell Biology, Saarland University, 66421 Homburg/Saar, Germany
| | - Silke Wemmert
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University, 66421 Homburg/Saar, Germany
| | - Martin Jung
- Institute of Medical Biochemistry and Molecular Biology, Saarland University, 66421 Homburg/Saar, Germany
| | - Joshua Gawlitza
- Institute of Radiology, Technical University of Munich, 80333 Munich, Germany
| | - Gentiana Wenzel
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University, 66421 Homburg/Saar, Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University, 66421 Homburg/Saar, Germany
| | - Thomas Tschernig
- Institute of Anatomy and Cell Biology, Saarland University, 66421 Homburg/Saar, Germany
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12
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Mueller SK, Wendler O, Mayr S, Traxdorf M, Hosemann W, Olze H, Steinhart H, Wiegand S, Teymoortash A, Kuehnel T, Hackenberg S, Hummel T, Ambrosch P, Fazel A, Schick B, Baenkler HW, Koch M, Buerner H, Mantsopoulos K, Grundtner P, Nocera A, Agaimy A, Bleier B, Iro H. Effect of postoperative systemic prednisolone on short-term and long-term outcomes in chronic rhinosinusitis with nasal polyps: A multi-centered randomized clinical trial. Front Immunol 2023; 14:1075066. [PMID: 36969262 PMCID: PMC10032209 DOI: 10.3389/fimmu.2023.1075066] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/16/2023] [Indexed: 03/11/2023] Open
Abstract
IntroductionThe objective of this study was to determine whether postoperative additive systemic steroid administration in chronic rhinosinusitis with nasal polyps (CRSwNP) impacted selected endoscopic, subjective and objective outcome measures.MethodsThis was a prospective, randomized, double-blind, placebo-controlled, noninferiority multicenter trial of n=106 patients with CRSwNP. All patients underwent primary functional endoscopic sinus surgery (FESS) followed by topical nasal steroids. Patients were randomized to a systemic steroid or placebo for 1 month. Patients were followed up for 2 years over 9 time points. The primary outcome measures were the differences between groups with respect to the nasal polyp score (NPS) and sinonasal quality of life (SNQoL). Secondary outcome measures included interactions with respect to the Lund-Kennedy score (LKS), sinonasal symptoms, general quality of life (GQoL), 16-item odor identification test scores, recurrence rates, need for revision surgery and mucus biomarker levels.Results106 patients were randomized to either the placebo or the systemic steroid group (n=53 per group). Postoperative systemic steroids were not superior to placebo with respect to all primary (p= 0.077) and secondary outcome measures (p>0.05 for all). Reported adverse events were similar between the two groups.ConclusionIn conclusion, the addition of postoperative systemic steroids after primary FESS did not confer a benefit over topical steroid nasal spray alone with respect to NPS, SNQOL, LKS, GQOL, sinonasal symptoms, smell scores, recurrence rates, the need for revision surgery or biomarkers over a short-term follow-up of up to 9 months and a long-term follow-up of up to 24 months in CRSwNP patients. Functional endoscopic surgery did, however, show a strong effect on all outcome measures, which remained relatively stable up to the endpoint at 2 years.
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Affiliation(s)
- Sarina K. Mueller
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- *Correspondence: Sarina K. Mueller,
| | - Olaf Wendler
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Susanne Mayr
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Maximilian Traxdorf
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Werner Hosemann
- Department of Otolaryngology, Head and Neck Surgery, Helios Hanseklinikum Stralsund, Stralsund, Germany
| | - Heidi Olze
- Department of Otolaryngology, Head and Neck Surgery, Universitätsklinikum Berlin, Berlin, Germany
| | - Helmut Steinhart
- Department of Otolaryngology, Head and Neck Surgery, Marienhospital Stuttgart, Stuttgart, Germany
| | - Susanne Wiegand
- Department of Otolaryngology, Head and Neck Surgery, Phillips Universität Marburg, Marburg, Germany
- Department of Otolaryngology, Head and Neck Surgery, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Afshin Teymoortash
- Department of Otolaryngology, Head and Neck Surgery, Phillips Universität Marburg, Marburg, Germany
| | - Thomas Kuehnel
- Department of Otolaryngology, Head and Neck Surgery, Universitätsklinikum Regensburg, Regensburg, Germany
| | - Stephan Hackenberg
- Department of Otolaryngology, Head and Neck Surgery, Universitätsklinikum Regensburg, Regensburg, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsklinikum Aachen, Aachen, Germany
| | - Thomas Hummel
- Department of Otolaryngology, Head and Neck Surgery, Smell and Taste Clinic, Universitätsklinikum Carl Gustav Carus Dresden, Dresden, Germany
| | - Petra Ambrosch
- Department of Otolaryngology, Head and Neck Surgery, Christian-Albrechts-Universität (CAU) Kiel, Kiel, Germany
| | - Azita Fazel
- Department of Otolaryngology, Head and Neck Surgery, Christian-Albrechts-Universität (CAU) Kiel, Kiel, Germany
| | - Bernhard Schick
- Department of Otolaryngology, Head and Neck Surgery, Universitätsklinikum des Saarlandes, Homburg, Germany
| | - Hanns-Wolf Baenkler
- Department of Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Koch
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Harald Buerner
- Department of Otolaryngology, Head and Neck Surgery, Marienhospital Stuttgart, Stuttgart, Germany
| | - Konstantinos Mantsopoulos
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Philipp Grundtner
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Angela Nocera
- Department of Otolaryngology Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA, United States
| | - Abbas Agaimy
- Department of Pathology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Benjamin Bleier
- Department of Otolaryngology Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA, United States
| | - Heinrich Iro
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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13
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Brockhaus R, Wenzel GI, Becker SL, Wagenpfeil G, Schick B, Gärtner B, Simon A. [Outpatient Antibiotic Prescription Rates and Mastoiditis in Children and Adolescents, Saarland, 2014-2019]. Klin Padiatr 2023; 235:23-30. [PMID: 34902871 DOI: 10.1055/a-1692-8923] [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] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Infections of the respiratory tract are the main indication for outpatient antibiotic therapy in children and adolescents. In recent years the antibiotic prescription rate (APR) in the pediatric population has decreased significantly. OBJECTIVES The aim of the retrospective mastoiditis audit in the PaedineSaar network is to investigate the incidence of inpatient acute mastoiditis (AM) in Saarland (2014-2019) regarding to the decreasing APRs in children, as well as to gather data of the clinical course of AM. METHODS All inpatient AM cases 2014-2019 were analyzed retrospectively from 6 hospitals for pediatrics and/or otorhinolaryngology in Saarland and Trier. Children and adolescents aged 0-17 years and residing in Saarland were included in the study. RESULTS 2014-2019 53 inpatient treated AM cases have been recorded. During the study period there was no significant increase of AM incidence (mean incidence 2014-2019: 6.1/100,000). 34% (18/53) of the patients received prehospital antibiotic treatment (main indication: acute otitis media (AOM) 15/18, 83%). At least one complication occurred in 30% of the patients (16/53). There was a slight trend to more complications in children without oral antibiotic treatment before admission (14/35 (40%) vs. 2/18 (11%) p=0.056). CONCLUSIONS The incidence of AM leading to inpatient treatment in children in Saarland did not increase 2014-2019 despite a significant and sustained decline in the outpatient APRs. The results of this audit should be used for the development of a more standardized approach concerning the diagnostics and treatment of children with AM.
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Affiliation(s)
- Rebekka Brockhaus
- Paediatric Hematology and Oncology, Children's Hospital Medical Center, Homburg, Deutschland
| | - Gentiana I Wenzel
- Otorhinolaryngology, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Deutschland
| | - Sören L Becker
- Medical Microbiology and Hygiene, Saarland University Medical Center, Homburg, Deutschland
| | - Gudrun Wagenpfeil
- Institutes for Medical Biometry, Epidemiology and Medical Informatics (IMBEI), Saarland University, Campus Homburg, Homburg, Deutschland
| | - Bernhard Schick
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes, Homburg, Deutschland
| | - Barbara Gärtner
- Instituites for Medical Microbiology and Hospital Hygiene, Universitätsklinikum des Saarlandes, Homburg, Deutschland.,Institues for Medical Microbiology and Hospital Hygiene, Hospital Hygiene and Infection Control, Homburg, Deutschland
| | - Arne Simon
- Paediatric Hematology and Oncology, Children's Hospital Medical Center, Homburg, Deutschland
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14
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Danisman Z, Linxweiler M, Kühn JP, Linxweiler B, Solomayer EF, Wagner M, Wagenpfeil G, Schick B, Berndt S. Differential nasal swab cytology represents a valuable tool for therapy monitoring but not prediction of therapy response in chronic rhinosinusitis with nasal polyps treated with Dupilumab. Front Immunol 2023; 14:1127576. [PMID: 37180133 PMCID: PMC10173305 DOI: 10.3389/fimmu.2023.1127576] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 12/19/2022] [Accepted: 03/22/2023] [Indexed: 05/15/2023] Open
Abstract
Introduction Chronic Rhinosinusitis with nasal polyps (CRSwNP) is a common chronic disease with a high impact on patients' quality of life. If conservative and surgical guideline treatment cannot sufficiently control disease burden, biologicals can be considered as a comparably new treatment option that has revolutionized CRSwNP therapy since the first approval of Dupilumab in 2019. With the aim to select patients who benefit from this new treatment and to find a marker for therapy monitoring, we investigated the cellular composition of nasal mucous membranes and inflammatory cells of patients suffering from CRSwNP and undergoing Dupilumab therapy using non-invasive nasal swab cytology. Methods Twenty CRSwNP patients with the indication for Dupilumab therapy have been included in this prospective clinical study. In total, five study visits were conducted with ambulatory nasal differential cytology using nasal swabs starting with the beginning of therapy and followed by visits every 3 months for 12 months. First, these cytology samples were stained with the May-Grunwald-Giemsa method (MGG) and the percentage of ciliated cells, mucinous cells, eosinophil cells, neutrophil cells, and lymphocytes was analyzed. Secondly, an immunocytochemical (ICC) ECP-staining was performed to detect eosinophil granulocytes. Additionally, during each study visit the nasal polyp score, SNOT20 questionnaire, olfactometry, the total IgE concentration in peripheral blood as well as the eosinophil cell count in peripheral blood were recorded. The change of parameters was evaluated over one year and the correlation between clinical effectiveness and nasal differential cytology was analyzed. Results In both MGG (p<0.0001) and ICC analysis (p<0.001) a significant decrease of eosinophils was seen under Dupilumab treatment. When patients were divided into a Eo-low- (<21%) and Eo-high- (≥21%) group according to the percentage eosinophils in nasal swab catology in the first study visit, the Eo-high-group showed a greater change of eosinophils over time (Δ17.82) compared to the Eo-low-group (Δ10.67) but, however, no better response to therapy. The polyp score, SNOT20 questionnaire, and total IgE concentration in peripheral blood showed a significant decrease during the observation period (p<0.0001). Discussion Nasal swab cytology as an easy-to-apply diagnostic method allows detection and quantification of the different cell populations within the nasal mucosa at a given time. The nasal differential cytology showed a significant decrease of eosinophils during Dupilumab therapy and can therefore be used as non-invasvive method for monitoring therapy success of this cost intensive therapy and potentially can allow an optimized individual therapy planning and management for CRSwNP patients. Since the validity of initial nasal swab eosinophil cell count as a predictive biomarker for therapy response was limited in our study, additional studies including larger number of participants will be necessary to further evaluate the potential benefits for clinical practice of this new diagnostic method.
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Affiliation(s)
- Zeynep Danisman
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarlandy University Medical Center, Homburg, Germany
| | - Maximilian Linxweiler
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarlandy University Medical Center, Homburg, Germany
| | - Jan Philipp Kühn
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarlandy University Medical Center, Homburg, Germany
| | - Barbara Linxweiler
- Department of Gynecology and Obstetrics, Saarland University Medical Center, Homburg, Germany
| | - Erich-Franz Solomayer
- Department of Gynecology and Obstetrics, Saarland University Medical Center, Homburg, Germany
| | - Mathias Wagner
- Department of General and Surgical Pathology, Saarland University Medical Center, Homburg, Germany
| | - Gudrun Wagenpfeil
- Department of Medical Biometry, Epidemiology and Medical Informations, Saarland University, Homburg, Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarlandy University Medical Center, Homburg, Germany
| | - Sabrina Berndt
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarlandy University Medical Center, Homburg, Germany
- *Correspondence: Sabrina Berndt,
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15
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Flockerzi V, Schick B, Bozzato A. [From the nose to the ear: field cancerization via the Eustachian tube]. HNO 2023; 71:177-179. [PMID: 36038751 PMCID: PMC9950206 DOI: 10.1007/s00106-022-01221-6] [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] [Accepted: 08/04/2022] [Indexed: 11/29/2022]
Abstract
We report on the metachronic appearance of an inverted papilloma in the ipsilateral middle ear after resection of an endonasal inverted papilloma and its malignant transformation. After multiple surgical interventions and adjuvant radiation and chemotherapy, there was recurrence with intracerebral growth, which ultimately led to the patient's death 3 years after the initial presentation.
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Affiliation(s)
- Veronika Flockerzi
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum des Saarlandes UKS, Kirrberger Str., Gebäude 6, 66421, Homburg, Deutschland.
| | - Bernhard Schick
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum des Saarlandes UKS, Kirrberger Str., Gebäude 6, 66421 Homburg, Deutschland
| | - Alessandro Bozzato
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum des Saarlandes UKS, Kirrberger Str., Gebäude 6, 66421 Homburg, Deutschland
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16
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Flockerzi V, Rink K, Schick B, Pillong L. [Neurootological examination - Guidance for diagnosis of acute vestibular syndrome]. Laryngorhinootologie 2022; 102:336-338. [PMID: 36513098 DOI: 10.1055/a-1937-6278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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17
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Linxweiler M, Reith W, Wagner M, Kühn JP, Schick B. Schwannoma of the Hypoglossal Nerve Mimicking Carotid Body Paraganglioma. Diagnostics (Basel) 2022; 12:diagnostics12092122. [PMID: 36140522 PMCID: PMC9498050 DOI: 10.3390/diagnostics12092122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/24/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
Carotid body paragangliomas (CBPs) clinically present as highly vascularized cervical masses with a pathognomonic localization at the carotid artery bifurcation. Following ultrasonography and MRI/CT imaging, surgical resection with optional preoperative embolization is considered as the treatment of choice in most cases. We herein present the case of a 60-year-old female with characteristic clinical signs and imaging findings of a right-sided CBP who finally went to surgical treatment. Intraoperatively, the tumor showed an adherent growth to the hypoglossal nerve that had to be partially resected, resulting in a postoperative nerve palsy. Histological examination of the resected tumor revealed the unexpected diagnosis of a hypoglossal nerve schwannoma. To the best of our knowledge, we herein present the third case reported in the literature of a unilateral hypoglossal schwannoma located at the carotid bifurcation mimicking clinical symptoms, imaging and intraoperative findings of a CBP.
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Affiliation(s)
- Maximilian Linxweiler
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, 66421 Homburg, Saar, Germany
- Correspondence: ; Tel.: +49-6841-1622928
| | - Wolfgang Reith
- Department of Diagnostic and Interventional Neuroradiology, Saarland University Medical Center, 66421 Homburg, Saar, Germany
| | - Mathias Wagner
- Department of General and Surgical Pathology, Saarland University Medical Center, 66421 Homburg, Saar, Germany
| | - Jan Philipp Kühn
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, 66421 Homburg, Saar, Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, 66421 Homburg, Saar, Germany
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18
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Körner S, Pick T, Bochen F, Wemmert S, Körbel C, Menger MD, Cavalié A, Kühn JP, Schick B, Linxweiler M. Antagonizing Sec62 function in intracellular Ca2+ homeostasis represents a novel therapeutic strategy for head and neck cancer. Front Physiol 2022; 13:880004. [PMID: 36045752 PMCID: PMC9421371 DOI: 10.3389/fphys.2022.880004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 06/30/2022] [Indexed: 12/24/2022] Open
Abstract
Various cancer types including head and neck squamous cell carcinomas (HNSCC) show a frequent amplification of chromosomal region 3q26 that encodes, among others, for the SEC62 gene. Located in the ER membrane, this translocation protein is known to play a critical role as a potential driver oncogene in cancer development. High SEC62 expression levels were observed in various cancer entities and were associated with a poor outcome and increased metastatic burden. Because of its intracellular localization the SEC62 protein is poorly accessible for therapeutic antibodies, therefore a functional SEC62 knockdown represents the most promising mechanism of a potential antineoplastic targeted therapy. By stimulating the Ca2+ efflux from the ER lumen and thereby increasing cellular stress levels, a functional inhibition of SEC62 bears the potential to limit tumor growth and metastasis formation. In this study, two potential anti-metastatic and -proliferative agents that counteract SEC62 function were investigated in functional in vitro assays by utilizing an immortalized human hypopharyngeal cancer cell line as well as a newly established orthotopic murine in vivo model. Additionally, a CRISPR/Cas9 based SEC62 knockout HNSCC cell line was generated and functionally characterized for its relevance in HNSCC cell proliferation and migration as well as sensitivity to SEC62 targeted therapy in vitro.
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Affiliation(s)
- Sandrina Körner
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Homburg, Germany
| | - Tillman Pick
- Experimental and Clinical Pharmacology and Toxicology, Pre-Clinical Center for Molecular Signalling (PSMZ), Saarland University, Homburg, Germany
| | - Florian Bochen
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Homburg, Germany
| | - Silke Wemmert
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Homburg, Germany
| | - Christina Körbel
- Institute for Clinical and Experimental Surgery, Saarland University, Homburg, Germany
| | - Michael D. Menger
- Institute for Clinical and Experimental Surgery, Saarland University, Homburg, Germany
| | - Adolfo Cavalié
- Experimental and Clinical Pharmacology and Toxicology, Pre-Clinical Center for Molecular Signalling (PSMZ), Saarland University, Homburg, Germany
| | - Jan-Philipp Kühn
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Homburg, Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Homburg, Germany
| | - Maximilian Linxweiler
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Homburg, Germany
- *Correspondence: Maximilian Linxweiler,
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Kühn JP, Bochen F, Körner S, Schick B, Wagner M, Smola S, Berkó-Göttel B, Morris LGT, Wang J, Bozzato A, Linxweiler M. Podoplanin expression in lymph node metastases of head and neck cancer and cancer of unknown primary patients. Int J Biol Markers 2022; 37:280-288. [PMID: 35880270 DOI: 10.1177/03936155221105524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Head and neck squamous cell carcinomas (HNSCCs) are cancers with generally poor prognosis. Outcomes have not improved in decades, with more than half of the patients presenting with lymph node metastases at the time of diagnosis. A unique subtype of HNSCC, cancer of unknown primary of the head and neck (HNCUP) is associated with a poor outcome. Increased expression of the D2-40 gene (podoplanin) has been described for several human malignancies and has been associated with increased metastatic potential of cancer cells. METHODS In order to examine the role of podoplanin in lymph node metastasis of HNSCC generally and HNCUP specifically, we evaluated the prognostic impact of podoplanin expression in HNSCC- (n = 68) and HNCUP-associated lymph node metastases (n = 30). The expression of podoplanin was analyzed by immunohistochemical staining of lymph node tissue samples and correlated with clinical and histopathological data. RESULTS We found a non-significant tendency towards a higher podoplanin expression in HNCUP compared to HNSCC lymph node metastases and a significant correlation between a high podoplanin expression and advanced node-stage classification. Podoplanin expression had no significant impact on overall survival for both groups and did not correlate with human papillomavirus tumor status. CONCLUSION Taken together, our results suggest that upregulation of podoplanin may be associated with a stimulation of lymphatic metastasis in head and neck cancer.
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Affiliation(s)
- Jan Philipp Kühn
- Department of Otorhinolaryngology, Head and Neck Surgery, 39072Saarland University Medical Center, Homburg, Germany
| | - Florian Bochen
- Department of Otorhinolaryngology, Head and Neck Surgery, 39072Saarland University Medical Center, Homburg, Germany
| | - Sandrina Körner
- Department of Otorhinolaryngology, Head and Neck Surgery, 39072Saarland University Medical Center, Homburg, Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Head and Neck Surgery, 39072Saarland University Medical Center, Homburg, Germany
| | - Mathias Wagner
- Department of General and Surgical Pathology, Saarland University Medical Center, Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, Homburg, Germany
| | | | - Luc G T Morris
- Department of Surgery, 5803Memorial Sloan Kettering Cancer Center, New York City, NY, USA.,Human Oncology and Pathogenesis Program, 39072Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | - Jingming Wang
- Human Oncology and Pathogenesis Program, 39072Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | - Alessandro Bozzato
- Department of Otorhinolaryngology, Head and Neck Surgery, 39072Saarland University Medical Center, Homburg, Germany
| | - Maximilian Linxweiler
- Department of Otorhinolaryngology, Head and Neck Surgery, 39072Saarland University Medical Center, Homburg, Germany
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Pillong L, Bozzato A, Hecker D, Bozzato V, Schick B, Kulas P. “A Head Start or a Pain in the Neck?”—Establishment and Evaluation of a Video-Based “Hands-On” Head and Neck Ultrasound Course. Diagnostics (Basel) 2022; 12:diagnostics12051239. [PMID: 35626394 PMCID: PMC9141540 DOI: 10.3390/diagnostics12051239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic has strongly highlighted the need for more digitalization in healthcare. Teaching ultrasound skills in online courses is a key challenge in this context. The aim of this study was to establish an online video-based head and neck ultrasound course with an evaluation of the quality, effectiveness, and feasibility of this teaching method compared to in-person teaching. Twenty-two medical students were taught head and neck ultrasound in two groups: one group in an in-person course and the other one in a video-based course. Learning success was analyzed using self-evaluation forms and external assessment by an experienced ultrasonographer. Comparing pre- and post-training self-evaluation, all participants showed statistically significant learning progress. In the external assessment, the overall scores in both groups did not differ significantly. The courses themselves were positively evaluated by all participants. Herein, we present the first feasibility study of a web-based head and neck-ultrasound course for medical students. The methodology provides the potential for future changes in telemedical education and sustainable improvements in telemedical teaching and global intra-clinical and interdisciplinary patient care.
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Linxweiler M, Kühn JP, Neubert C, Khreish F, Balensiefer B, Wagner M, Schick B. Complete remission of an early-stage laryngeal cancer under combined pembrolizumab and chemotherapy treatment of a synchronous lung adenocarcinoma. J Otolaryngol Head Neck Surg 2022; 51:21. [PMID: 35578359 PMCID: PMC9109389 DOI: 10.1186/s40463-022-00572-y] [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: 10/23/2021] [Accepted: 03/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anti-PD1-Checkpoint inhibition (CI) is an established treatment of recurrent and/or metastatic head and neck cancer. A potential benefit from CI in early-stage disease that is usually treated by radiation or surgery has not been investigated so far and is currently not addressed in clinical trials. CASE PRESENTATION A 58-year-old man was diagnosed with a cT2 supraglottic laryngeal cancer and a synchronous metastasized adenocarcinoma of the lung. As the patient refused any treatment of his laryngeal cancer, he received combined immune-chemotherapy according to the KEYNOTE-189 protocol. After 4 cycles of pembrolizumab/carboplatin/pemetrexed, the patient showed a complete remission of his laryngeal cancer with a clear shrinkage of the mediastinal and hilar lung cancer metastases. After 21 cycles of maintenance therapy, the lung adenocarcinoma shows a stable disease status with no signs of any residual or recurrent laryngeal cancer. CONCLUSIONS Anti-PD1-CI may be a treatment option also for early-stage HNSCC with excellent functional outcome when established therapies are not available.
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Affiliation(s)
- Maximilian Linxweiler
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Kirrbergerstr. 100, Building 6, 66421, Homburg/Saar, Germany.
| | - Jan Philipp Kühn
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Kirrbergerstr. 100, Building 6, 66421, Homburg/Saar, Germany
| | - Christian Neubert
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Kirrbergerstr. 100, Building 6, 66421, Homburg/Saar, Germany
| | - Fadi Khreish
- Department of Nuclear Medicine, Saarland University Medical Center, Homburg/Saar, Germany
| | - Benedikt Balensiefer
- Department of Hematology, Oncology, Clinical Immunology and Rheumatology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Mathias Wagner
- Department of General and Surgical Pathology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Kirrbergerstr. 100, Building 6, 66421, Homburg/Saar, Germany
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22
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Boewe AS, Wemmert S, Kulas P, Schick B, Götz C, Wrublewsky S, Montenarh M, Menger MD, Laschke MW, Ampofo E. Inhibition of CK2 Reduces NG2 Expression in Juvenile Angiofibroma. Biomedicines 2022; 10:biomedicines10050966. [PMID: 35625703 PMCID: PMC9138789 DOI: 10.3390/biomedicines10050966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 12/04/2022] Open
Abstract
Juvenile angiofibroma (JA) is a rare fibrovascular neoplasm predominately found within the posterior nasal cavity of adolescent males. JA expresses the proteoglycan nerve–glial antigen (NG)2, which crucially determines the migratory capacity of distinct cancer cells. Moreover, it is known that the protein kinase CK2 regulates NG2 gene expression. Therefore, in the present study, we analyzed whether the inhibition of CK2 suppresses NG2-dependent JA cell proliferation and migration. For this purpose, we assessed the expression of NG2 and CK2 in patient-derived JA tissue samples, as well as in patient-derived JA cell cultures by Western blot, immunohistochemistry, flow cytometry and quantitative real-time PCR. The mitochondrial activity, proliferation and migratory capacity of the JA cells were determined by water-soluble tetrazolium (WST)-1, 5-bromo-2′-deoxyuridine (BrdU) and collagen sprouting assays. We found that NG2 and CK2 were expressed in both the JA tissue samples and cell cultures. The treatment of the JA cells with the two CK2 inhibitors, CX-4945 and SGC-CK2-1, significantly reduced NG2 gene and protein expression when compared to the vehicle-treated cells. In addition, the loss of CK2 activity suppressed the JA cell proliferation and migration. These findings indicate that the inhibition of CK2 may represent a promising therapeutic approach for the treatment of NG2-expressing JA.
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Affiliation(s)
- Anne S. Boewe
- Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg, Germany; (A.S.B.); (S.W.); (M.D.M.); (M.W.L.)
| | - Silke Wemmert
- Department of Otolaryngology, Saarland University Medical Center, 66421 Homburg, Germany; (S.W.); (P.K.); (B.S.)
| | - Philipp Kulas
- Department of Otolaryngology, Saarland University Medical Center, 66421 Homburg, Germany; (S.W.); (P.K.); (B.S.)
| | - Bernhard Schick
- Department of Otolaryngology, Saarland University Medical Center, 66421 Homburg, Germany; (S.W.); (P.K.); (B.S.)
| | - Claudia Götz
- Medical Biochemistry and Molecular Biology, Saarland University, 66421 Homburg, Germany; (C.G.); (M.M.)
| | - Selina Wrublewsky
- Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg, Germany; (A.S.B.); (S.W.); (M.D.M.); (M.W.L.)
| | - Mathias Montenarh
- Medical Biochemistry and Molecular Biology, Saarland University, 66421 Homburg, Germany; (C.G.); (M.M.)
| | - Michael D. Menger
- Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg, Germany; (A.S.B.); (S.W.); (M.D.M.); (M.W.L.)
| | - Matthias W. Laschke
- Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg, Germany; (A.S.B.); (S.W.); (M.D.M.); (M.W.L.)
| | - Emmanuel Ampofo
- Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg, Germany; (A.S.B.); (S.W.); (M.D.M.); (M.W.L.)
- Correspondence: ; Tel.: +49-6841-16-26561; Fax: +49-6841-16-26553
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Linxweiler M, Körner S, Wemmert S, Rimbach H, Helfrich J, Linxweiler B, Takacs ZF, Solomayer EF, Wagner M, Morris LGT, Schick B, Kühn JP. Cytology-based Cancer Surgery of the Head and Neck (CyCaS-HN): a prospective, randomized, controlled clinical trial. Eur Arch Otorhinolaryngol 2022; 279:4505-4514. [PMID: 35305137 PMCID: PMC9363327 DOI: 10.1007/s00405-022-07333-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/28/2022] [Indexed: 11/29/2022]
Abstract
Purpose Liquid-based cytology (LBC) is routinely used in gynecology but is rarely applied in head and neck oncology though many suspicious lesions are easily accessible. While several studies have evaluated the potential use of LBC for early detection and molecular characterization of head and neck squamous cell carcinomas (HNSCCs), no study investigated its potential role in surgical management and therapy planning so far. Methods Twenty-five patients with cT1-2 squamous cell carcinomas of the oral cavity and oropharynx were prospectively enrolled in this study and were randomized to two treatment arms: in the control arm, a diagnostic panendoscopy with incisional biopsy was followed by a second operation with transoral tumor resection ± neck dissection and tracheostomy. In the intervention arm, patients underwent LBC diagnostics and in case of a positive result received one single operation with panendoscopy and incisional biopsy for confirmation of LBC result by rapid section histology followed by transoral tumor resection ± neck dissection and tracheostomy in the same session. Results Time between clinical diagnosis and definitive surgical treatment was significantly shorter in the intervention group compared with the control group (p < 0.0001). Additionally, time of hospitalization (p < 0.0001) and cumulative operation time (p = 0.062) were shorter in the intervention group. No significant differences in overall, progression-free, and disease-specific survival were observed. Conclusion Cytology-based cancer surgery is a promising therapeutic strategy that can potentially be considered for a well-defined group of early-stage HNSCC patients and help to avoid repetitive general anesthesia, shorten the diagnosis-to-treatment interval and spare operation as well as hospitalization time.
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Affiliation(s)
- Maximilian Linxweiler
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Kirrbergerstr. 100, building 6, 66421, Homburg, Germany.
| | - Sandrina Körner
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Kirrbergerstr. 100, building 6, 66421, Homburg, Germany
| | - Silke Wemmert
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Kirrbergerstr. 100, building 6, 66421, Homburg, Germany
| | - Hugo Rimbach
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Kirrbergerstr. 100, building 6, 66421, Homburg, Germany
| | - Johanna Helfrich
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Kirrbergerstr. 100, building 6, 66421, Homburg, Germany
| | - Barbara Linxweiler
- Department of Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | - Zoltan Ferenc Takacs
- Department of Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | - Erich Franz Solomayer
- Department of Gynecology, Obstetrics and Reproductive Medicine, Saarland University Medical Center, Homburg, Germany
| | - Mathias Wagner
- Department of General and Surgical Pathology, Saarland University Medical Center, Homburg, Germany
| | - Luc G T Morris
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York City, NY, USA.,Immunogenomics and Precision Oncology Platform, Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | - Bernhard Schick
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Kirrbergerstr. 100, building 6, 66421, Homburg, Germany
| | - Jan Philipp Kühn
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Kirrbergerstr. 100, building 6, 66421, Homburg, Germany
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Kühn JP, Linsler S, Nourkami-Tutdibi N, Meyer S, Becker SL, Yilmaz U, Schick B, Bozzato A, Kulas P. [Pott's Puffy Tumor: a need for interdisciplinary diagnosis and treatment. German Version]. HNO 2022; 70:550-556. [PMID: 35260911 PMCID: PMC9242906 DOI: 10.1007/s00106-021-01133-x] [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] [Accepted: 10/29/2021] [Indexed: 11/29/2022]
Abstract
Der Pott-Puffy-Tumor (PPT) stellt als bakterielle Infektion des Sinus frontalis mit subperiostaler und intrakranieller Abszessbildung eine seltene Erkrankung in der Pädiatrie dar. Nachfolgend präsentieren wir vier Fälle eines PPT, die bei zwei Kindern (6 und 9 Jahre) und bei zwei jungen Erwachsenen (17 und 19 Jahre) auftraten. Alle Patienten wurden interdisziplinär von einem Team aus Neurochirurgie, Pädiatrie, HNO-Heilkunde, Neuroradiologie und Mikrobiologie betreut. Die Antibiotikabehandlung wurde in einem Fall mit einer endoskopischen Nasennebenhöhlenoperation (FESS) und in den anderen drei Fällen zusätzlich mit einem offenen transkraniellen Zugang zur Drainage der intrakraniellen Abszessbildung kombiniert. Da der PPT im Kindesalter mit dem Befund einer intrakraniellen Abszessbildung einhergehen kann, ist eine enge interdisziplinäre Zusammenarbeit für eine erfolgreiche Behandlung dieser seltenen Erkrankung erforderlich.
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Affiliation(s)
- Jan Philipp Kühn
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes, Kirrberger Straße, 66421, Homburg, Deutschland.
| | - Stefan Linsler
- Klinik für Neurochirurgie, Universitätsklinikum des Saarlandes, Homburg, Deutschland
| | - Nasenien Nourkami-Tutdibi
- Klinik für Allgemeine Pädiatrie und Neonatologie, Universitätsklinikum des Saarlandes, Homburg, Deutschland
| | - Sascha Meyer
- Klinik für Allgemeine Pädiatrie und Neonatologie, Universitätsklinikum des Saarlandes, Homburg, Deutschland
| | - Sören L Becker
- Institut für Medizinische Mikrobiologie und Hygiene, Institute für Infektionsmedizin, Universitätsklinikum des Saarlandes, Homburg, Deutschland
| | - Umut Yilmaz
- Klinik für diagnostische und interventionelle Neuroradiologie, Universitätsklinikum des Saarlandes, Homburg, Deutschland
| | - Bernhard Schick
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes, Kirrberger Straße, 66421, Homburg, Deutschland
| | - Alessandro Bozzato
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes, Kirrberger Straße, 66421, Homburg, Deutschland
| | - Philipp Kulas
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes, Kirrberger Straße, 66421, Homburg, Deutschland
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Schick B, Pillong L, Wenzel G, Wemmert S. Neural Crest Stem Cells in Juvenile Angiofibromas. Int J Mol Sci 2022; 23:ijms23041932. [PMID: 35216046 PMCID: PMC8875494 DOI: 10.3390/ijms23041932] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/03/2022] [Accepted: 02/06/2022] [Indexed: 02/05/2023] Open
Abstract
The etiology of juvenile angiofibroma (JA) has been a controversial topic for more than 160 years. Numerous theories have been proposed to explain this rare benign neoplasm arising predominately in adolescent males, focusing mainly on either the vascular or fibrous component. To assess our hypothesis of JA’s being a malformation arising from neural crest cells/remnants of the first branchial arch plexus, we performed immunohistochemical analyses of neural crest stem cells (NCSC) and epithelial-mesenchymal transition (EMT) candidates. Immunoexpression of the NCSC marker CD271p75 was observed in all investigated JA’s (n = 22), mainly around the pathological vessels. Close to CD271p75-positive cells, high MMP3-staining was also observed. Additionally, from one JA with sufficient material, RT-qPCR identified differences in the expression pattern of PDGFRβ, MMP2 and MMP3 in MACS®-separated CD271p75positive vs. CD271p75 negative cell fractions. Our results, together with the consideration of the literature, provide evidence that JA’s represent a malformation within the first branchial arch artery/plexus remnants deriving from NCSC. This theory would explain the typical site of tumor origin as well as the characteristic tumor blood supply, whereas the process of EMT provides an explanation for the vascular and fibrous tumor component.
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Schick B, Schmid S, Mayer B, Wagner D, Walter S, Gruss S, Jungwirth B, Barth E. [Potential effect of the stimulus threshold level of the nociceptive flexion reflex (NFRT) on mortality and delirium incidence in the critically ill patient: a retrospective cohort analysis]. Anaesthesiologie 2022; 71:921-929. [PMID: 36166064 PMCID: PMC9514181 DOI: 10.1007/s00101-022-01206-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/05/2022] [Accepted: 08/25/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Mortality and delirium in critically ill patients are affected by the provided analgesics and sedatives. The deeper the sedation and the higher the dose of analgesics applied, the more difficult it is to assess pain and the depth of sedation. Therefore, instrumental measurement methods, such as the measurement of the stimulus threshold of the nociceptive flexion reflex (NFRT), are becoming increasingly more important. OBJECTIVE The aim of the present study is to investigate a potential association between the level of the nociceptive flexion reflex, mortality, and the occurrence of delirium. MATERIAL AND METHODS By retrospectively analyzing a pilot data set of 57 ICU patients from the interdisciplinary surgical ICU of Ulm University Hospital surveyed between 11/2018 and 03/2020, a possible association between the NFRT, mortality, and the occurrence of delirium was calculated in an adjusted logistic regression model. Depending on the cut-off value, the stimulus threshold corridors result in the following comparison pairs: < 20 mA vs. 20-40 mA/20-50 mA/20-60 mA, > 40 mA vs. 20-40 mA, > 50 mA vs. 20-50 mA and > 60 mA vs. 20-60 mA. Results are presented as odds ratios (OR) adjusted for age, sex, height, TISS-28, SAPS II, RASS, BPS, and applied analgesics. Pain assessment was performed, in addition to the Behavioral Pain scale, ≥ 3 times daily by measuring NFRT. RESULTS A statistically nonsignificant tendency for an increase in mortality incidence occurred with an NFRT > 50 mA, versus a stimulus threshold corridor of 20-50 mA (OR 3.3, CI: 0.89-12.43, p = 0.07). A trend toward a reduction in delirium incidence occurred at an NFRT < 20 mA, versus a stimulus threshold corridor of 20-40 mA (OR 0.40, CI: 0.18-0.92, p = 0.03). CONCLUSION Based on the level of the NFRT, no recommendation can be made at this point to adjust the analgesic regimen of critically ill patients, who are unable to communicate. The observation of a tendency towards an increase in mortality at high stimulus thresholds or a reduction in the occurrence of delirium at low stimulus thresholds of the NFRT must be verified in standardized studies.
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Affiliation(s)
- B. Schick
- grid.410712.10000 0004 0473 882XKlinik für Anästhesiologie und Intensivmedizin, Sektion Interdisziplinäre Operative Intensivmedizin, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Deutschland
| | - S. Schmid
- grid.410712.10000 0004 0473 882XKlinik für Anästhesiologie und Intensivmedizin, Sektion Interdisziplinäre Operative Intensivmedizin, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Deutschland
| | - B. Mayer
- grid.6582.90000 0004 1936 9748Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Schwabstr. 13, 89075 Ulm, Deutschland
| | - D. Wagner
- grid.410712.10000 0004 0473 882XKlinik für Anästhesiologie und Intensivmedizin, Sektion Interdisziplinäre Operative Intensivmedizin, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Deutschland
| | - S. Walter
- grid.6582.90000 0004 1936 9748Klinik für Psychosomatische Medizin und Psychotherapie, Sektion medizinische Psychologie, Universität Ulm, Frauensteige 6, 89075 Ulm, Deutschland
| | - S. Gruss
- grid.6582.90000 0004 1936 9748Klinik für Psychosomatische Medizin und Psychotherapie, Sektion medizinische Psychologie, Universität Ulm, Frauensteige 6, 89075 Ulm, Deutschland
| | - B. Jungwirth
- grid.410712.10000 0004 0473 882XKlinik für Anästhesiologie und Intensivmedizin, Sektion Interdisziplinäre Operative Intensivmedizin, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Deutschland
| | - E. Barth
- grid.410712.10000 0004 0473 882XKlinik für Anästhesiologie und Intensivmedizin, Sektion Interdisziplinäre Operative Intensivmedizin, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Deutschland
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Hartmann S, Scharf S, Steiner Y, Loth AG, Donnadieu E, Flinner N, Poeschel V, Angel S, Bewarder M, Bein J, Brunnberg U, Bozzato A, Schick B, Stilgenbauer S, Bohle RM, Thurner L, Hansmann ML. Landscape of 4D Cell Interaction in Hodgkin and Non-Hodgkin Lymphomas. Cancers (Basel) 2021; 13:cancers13205208. [PMID: 34680356 PMCID: PMC8534096 DOI: 10.3390/cancers13205208] [Citation(s) in RCA: 3] [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: 09/14/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 12/23/2022] Open
Abstract
Simple Summary Little is known about the motility and interaction of primary human lymphoma cells in lymph nodes. The aim of this study therefore was to analyze for the first time if there are differences in motility and interaction with bystander cells between different lymphoma types and normal lymph nodes. We observed systematic differences between B cells and PD1-positive T cells. Furthermore, most cases of Hodgkin lymphomas had fast moving PD1-positive T cells, whereas there was little movement in other lymphoma types. Some lymphomas, particularly Hodgkin lymphomas, presented enhanced cell contacts between neoplastic and reactive cells, suggesting a dependency of lymphoma growth on cellular interaction. Abstract Profound knowledge exists about the clinical, morphologic, genomic, and transcriptomic characteristics of most lymphoma entities. However, information is currently lacking on the dynamic behavior of malignant lymphomas. This pilot study aimed to gain insight into the motility of malignant lymphomas and bystander cells in 20 human lymph nodes. Generally, B cells were faster under reactive conditions compared with B cells in malignant lymphomas. In contrast, PD1-positive T cells did not show systematic differences in velocity between reactive and neoplastic conditions in general. However, lymphomas could be divided into two groups: one with fast PD1-positive T cells (e.g., Hodgkin lymphoma and mantle cell lymphoma; means 8.4 and 7.8 µm/min) and another with slower PD1-positive T cells (e.g., mediastinal grey zone lymphoma; mean 3.5 µm/min). Although the number of contacts between lymphoma cells and PD1-positive T cells was similar in different lymphoma types, important differences were observed in the duration of these contacts. Among the lymphomas with fast PD1-positive T cells, contacts were particularly short in mantle cell lymphoma (mean 54 s), whereas nodular lymphocyte-predominant Hodgkin lymphoma presented prolonged contact times (mean 6.1 min). Short contact times in mantle cell lymphoma were associated with the largest spatial displacement of PD1-positive cells (mean 12.3 µm). Although PD1-positive T cells in nodular lymphocyte-predominant Hodgkin lymphoma were fast, they remained in close contact with the lymphoma cells, in line with a dynamic immunological synapse. This pilot study shows for the first time systematic differences in the dynamic behavior of lymphoma and bystander cells between different lymphoma types.
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Affiliation(s)
- Sylvia Hartmann
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; (Y.S.); (N.F.); (J.B.)
- Correspondence: ; Tel.: +49-69-6301-4284
| | - Sonja Scharf
- Frankfurt Institute of Advanced Studies, 60438 Frankfurt am Main, Germany; (S.S.); (M.-L.H.)
- Molecular Bioinformatics, Institute of Computer Science, Goethe University Frankfurt am Main, Robert-Mayer-Straße 11-15, 60325 Frankfurt am Main, Germany
| | - Yvonne Steiner
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; (Y.S.); (N.F.); (J.B.)
| | - Andreas G. Loth
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany;
| | - Emmanuel Donnadieu
- Institut Cochin, INSERM U1016/CNRS UMR 8104, Université de Paris, 75014 Paris, France;
| | - Nadine Flinner
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; (Y.S.); (N.F.); (J.B.)
- Frankfurt Institute of Advanced Studies, 60438 Frankfurt am Main, Germany; (S.S.); (M.-L.H.)
| | - Viola Poeschel
- Internal Medicine I, Saarland University Medical School, 66421 Homburg, Germany; (V.P.); (S.A.); (M.B.); (S.S.); (L.T.)
| | - Stephanie Angel
- Internal Medicine I, Saarland University Medical School, 66421 Homburg, Germany; (V.P.); (S.A.); (M.B.); (S.S.); (L.T.)
| | - Moritz Bewarder
- Internal Medicine I, Saarland University Medical School, 66421 Homburg, Germany; (V.P.); (S.A.); (M.B.); (S.S.); (L.T.)
| | - Julia Bein
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; (Y.S.); (N.F.); (J.B.)
| | - Uta Brunnberg
- Department of Internal Medicine 2, Goethe University Hospital, 60590 Frankfurt am Main, Germany;
| | - Alessandro Bozzato
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, 66421 Homburg, Germany; (A.B.); (B.S.)
| | - Bernhard Schick
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, 66421 Homburg, Germany; (A.B.); (B.S.)
| | - Stephan Stilgenbauer
- Internal Medicine I, Saarland University Medical School, 66421 Homburg, Germany; (V.P.); (S.A.); (M.B.); (S.S.); (L.T.)
- Comprehensive Cancer Center Ulm (CCCU), University Hospital Ulm, 89070 Ulm, Germany
| | - Rainer M. Bohle
- Institute of Pathology, Saarland University Medical School, 66421 Homburg, Germany;
| | - Lorenz Thurner
- Internal Medicine I, Saarland University Medical School, 66421 Homburg, Germany; (V.P.); (S.A.); (M.B.); (S.S.); (L.T.)
- José Carreras Center for Immuno- and Gene Therapy, Saarland University Medical School, 66421 Homburg, Germany
| | - Martin-Leo Hansmann
- Frankfurt Institute of Advanced Studies, 60438 Frankfurt am Main, Germany; (S.S.); (M.-L.H.)
- Institute of General Pharmacology and Toxicology, Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
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Moreira Lana G, Sorg K, Wenzel GI, Hecker D, Hensel R, Schick B, Kruttwig K, Arzt E. Self‐Adhesive Silicone Microstructures for the Treatment of Tympanic Membrane Perforations. Adv NanoBio Res 2021. [DOI: 10.1002/anbr.202170101] [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: 11/09/2022] Open
Affiliation(s)
- Gabriela Moreira Lana
- INM – Leibniz Institute for New Materials Campus D2 2 Saarbrücken 66123 Germany
- Department of Materials Science and Engineering Saarland University Campus D2 2 Saarbrücken 66123 Germany
| | - Katharina Sorg
- Department of Otorhinolaryngology Saarland University Medical Center Homburg 66421 Germany
| | - Gentiana Ioana Wenzel
- Department of Otorhinolaryngology Saarland University Medical Center Homburg 66421 Germany
| | - Dietmar Hecker
- Department of Otorhinolaryngology Saarland University Medical Center Homburg 66421 Germany
| | - René Hensel
- INM – Leibniz Institute for New Materials Campus D2 2 Saarbrücken 66123 Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology Saarland University Medical Center Homburg 66421 Germany
| | - Klaus Kruttwig
- INM – Leibniz Institute for New Materials Campus D2 2 Saarbrücken 66123 Germany
| | - Eduard Arzt
- INM – Leibniz Institute for New Materials Campus D2 2 Saarbrücken 66123 Germany
- Department of Materials Science and Engineering Saarland University Campus D2 2 Saarbrücken 66123 Germany
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Kühn JP, Schmid W, Körner S, Bochen F, Wemmert S, Rimbach H, Smola S, Radosa JC, Wagner M, Morris LG, Bozzato V, Bozzato A, Schick B, Linxweiler M. HPV Status as Prognostic Biomarker in Head and Neck Cancer-Which Method Fits the Best for Outcome Prediction? Cancers (Basel) 2021; 13:cancers13184730. [PMID: 34572957 PMCID: PMC8469433 DOI: 10.3390/cancers13184730] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/11/2021] [Accepted: 09/20/2021] [Indexed: 01/22/2023] Open
Abstract
The incidence of human papillomavirus (HPV)-related head and neck cancer (HNSCC) is rising globally, presenting challenges for optimized clinical management. To date, it remains unclear which biomarker best reflects HPV-driven carcinogenesis, a process that is associated with better therapeutic response and outcome compared to tobacco/alcohol-induced cancers. Six potential HPV surrogate biomarkers were analyzed using FFPE tissue samples from 153 HNSCC patients (n = 78 oropharyngeal cancer (OPSCC), n = 35 laryngeal cancer, n = 23 hypopharyngeal cancer, n = 17 oral cavity cancer): p16, CyclinD1, pRb, dual immunohistochemical staining of p16 and Ki67, HPV-DNA-PCR, and HPV-DNA-in situ hybridization (ISH). Biomarkers were analyzed for correlation with one another, tumor subsite, and patient survival. P16-IHC alone showed the best performance for discriminating between good (high expression) vs poor outcome (low expression; p = 0.0030) in OPSCC patients. Additionally, HPV-DNA-ISH (p = 0.0039), HPV-DNA-PCR (p = 0.0113), and p16-Ki67 dual stain (p = 0.0047) were significantly associated with prognosis in uni- and multivariable analysis for oropharyngeal cancer. In the non-OPSCC group, however, none of the aforementioned surrogate markers was prognostic. Taken together, P16-IHC as a single biomarker displays the best diagnostic accuracy for prognosis stratification in OPSCC patients with a direct detection of HPV-DNA by PCR or ISH as well as p16-Ki67 dual stain as potential alternatives.
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Affiliation(s)
- Jan Philipp Kühn
- Department of Otorhinolaryngology, Saarland University Medical Center, D-66421 Homburg, Germany; (J.P.K.); (W.S.); (S.K.); (F.B.); (S.W.); (H.R.); (V.B.); (A.B.); (B.S.)
| | - Wendelin Schmid
- Department of Otorhinolaryngology, Saarland University Medical Center, D-66421 Homburg, Germany; (J.P.K.); (W.S.); (S.K.); (F.B.); (S.W.); (H.R.); (V.B.); (A.B.); (B.S.)
| | - Sandrina Körner
- Department of Otorhinolaryngology, Saarland University Medical Center, D-66421 Homburg, Germany; (J.P.K.); (W.S.); (S.K.); (F.B.); (S.W.); (H.R.); (V.B.); (A.B.); (B.S.)
| | - Florian Bochen
- Department of Otorhinolaryngology, Saarland University Medical Center, D-66421 Homburg, Germany; (J.P.K.); (W.S.); (S.K.); (F.B.); (S.W.); (H.R.); (V.B.); (A.B.); (B.S.)
| | - Silke Wemmert
- Department of Otorhinolaryngology, Saarland University Medical Center, D-66421 Homburg, Germany; (J.P.K.); (W.S.); (S.K.); (F.B.); (S.W.); (H.R.); (V.B.); (A.B.); (B.S.)
| | - Hugo Rimbach
- Department of Otorhinolaryngology, Saarland University Medical Center, D-66421 Homburg, Germany; (J.P.K.); (W.S.); (S.K.); (F.B.); (S.W.); (H.R.); (V.B.); (A.B.); (B.S.)
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, D-66421 Homburg, Germany;
| | - Julia Caroline Radosa
- Department of Gynecology and Obstetrics, Saarland University Medical Center, D-66421 Homburg, Germany;
| | - Mathias Wagner
- Department of General and Surgical Pathology, Saarland University Medical Center, D-66421 Homburg, Germany;
| | - Luc G.T. Morris
- Immunogenomics and Precision Oncology Platform, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA;
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Victoria Bozzato
- Department of Otorhinolaryngology, Saarland University Medical Center, D-66421 Homburg, Germany; (J.P.K.); (W.S.); (S.K.); (F.B.); (S.W.); (H.R.); (V.B.); (A.B.); (B.S.)
| | - Alessandro Bozzato
- Department of Otorhinolaryngology, Saarland University Medical Center, D-66421 Homburg, Germany; (J.P.K.); (W.S.); (S.K.); (F.B.); (S.W.); (H.R.); (V.B.); (A.B.); (B.S.)
| | - Bernhard Schick
- Department of Otorhinolaryngology, Saarland University Medical Center, D-66421 Homburg, Germany; (J.P.K.); (W.S.); (S.K.); (F.B.); (S.W.); (H.R.); (V.B.); (A.B.); (B.S.)
| | - Maximilian Linxweiler
- Department of Otorhinolaryngology, Saarland University Medical Center, D-66421 Homburg, Germany; (J.P.K.); (W.S.); (S.K.); (F.B.); (S.W.); (H.R.); (V.B.); (A.B.); (B.S.)
- Correspondence: ; Tel.: +49-6841-1622928
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Sorg K, Heimann L, Lana GM, Langenbucher A, Schick B, Arzt E, Wenzel GI. Optoacoustically induced auditory brainstem responses in the mouse model enhanced through an absorbing film. J Biomed Opt 2021; 26:JBO-210173R. [PMID: 34480448 PMCID: PMC8414560 DOI: 10.1117/1.jbo.26.9.098001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
SIGNIFICANCE Optoacoustic stimulation offers an alternative stimulation strategy for the hearing organ. To serve as the base for a novel auditory prosthesis, the optoacoustic stimulation must be biocompatible and energy-saving. AIM Enhancing the efficiency of optoacoustic stimulation while reducing the energy input in a suited animal model. APPROACH Optoacoustically induced auditory brainstem responses (oABRs) were recorded after the pulsed laser irradiation of the tympanic membrane (TM) in mice. The results were compared with the ABRs induced through acoustic click stimulation. In addition, self-adhesive absorbing films were applied on the TM before the optoacoustic stimulation to investigate their effect on the resulting ABRs. RESULTS Using an absorbing film on the TM during optical stimulation led to considerably enhanced oABR wave I amplitude values compared with the stimulation of the bare TM. When using our stimulation strategy, we induced oABR waves in the 50% to 60% range of the acoustical stimulation reached with 80-dB SPL click stimuli. CONCLUSIONS The mouse model can be used for certain developmental work for an optoacoustic auditory prosthesis. Using absorbing films on the TM during optical stimulation considerably enhances oABR wave I amplitude. Optimization of the stimulation strategy could further enhance the efficiency within biocompatibility margins.
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Affiliation(s)
- Katharina Sorg
- Saarland University Medical Center, Department of Otorhinolaryngology, Homburg, Germany
| | - Larissa Heimann
- Saarland University Medical Center, Department of Otorhinolaryngology, Homburg, Germany
| | - Gabriela Moreira Lana
- INM Leibniz Institute for New Materials, Saarbrücken, Germany
- Saarland University, Department of Materials Science and Engineering, Saarbrücken, Germany
| | - Achim Langenbucher
- Saarland University, Department of Experimental Ophthalmology, Homburg, Germany
| | - Bernhard Schick
- Saarland University Medical Center, Department of Otorhinolaryngology, Homburg, Germany
| | - Eduard Arzt
- INM Leibniz Institute for New Materials, Saarbrücken, Germany
- Saarland University, Department of Materials Science and Engineering, Saarbrücken, Germany
| | - Gentiana Ioana Wenzel
- Saarland University Medical Center, Department of Otorhinolaryngology, Homburg, Germany
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Moreira Lana G, Sorg K, Wenzel GI, Hecker D, Hensel R, Schick B, Kruttwig K, Arzt E. Self‐Adhesive Silicone Microstructures for the Treatment of Tympanic Membrane Perforations. Adv NanoBio Res 2021. [DOI: 10.1002/anbr.202100057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Gabriela Moreira Lana
- INM – Leibniz Institute for New Materials Campus D2 2 Saarbrücken 66123 Germany
- Department of Materials Science and Engineering Saarland University Campus D2 2 Saarbrücken 66123 Germany
| | - Katharina Sorg
- Department of Otorhinolaryngology Saarland University Medical Center Homburg 66421 Germany
| | - Gentiana Ioana Wenzel
- Department of Otorhinolaryngology Saarland University Medical Center Homburg 66421 Germany
| | - Dietmar Hecker
- Department of Otorhinolaryngology Saarland University Medical Center Homburg 66421 Germany
| | - René Hensel
- INM – Leibniz Institute for New Materials Campus D2 2 Saarbrücken 66123 Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology Saarland University Medical Center Homburg 66421 Germany
| | - Klaus Kruttwig
- INM – Leibniz Institute for New Materials Campus D2 2 Saarbrücken 66123 Germany
| | - Eduard Arzt
- INM – Leibniz Institute for New Materials Campus D2 2 Saarbrücken 66123 Germany
- Department of Materials Science and Engineering Saarland University Campus D2 2 Saarbrücken 66123 Germany
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Kühn JP, Vogt T, Schick B. [A cervical inflammation and signs of sepsis]. HNO 2021; 69:501-503. [PMID: 32876718 DOI: 10.1007/s00106-020-00936-8] [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: 11/24/2022]
Affiliation(s)
- J P Kühn
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes, Kirrberger Straße, 66421, Homburg, Deutschland.
| | - T Vogt
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum des Saarlandes, Homburg, Deutschland
| | - B Schick
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes, Kirrberger Straße, 66421, Homburg, Deutschland
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Müller CSL, Pföhler C, Wahl M, Bochen F, Körner S, Kühn JP, Bozzato A, Schick B, Linxweiler M. Expression of SEC62 Oncogene in Benign, Malignant and Borderline Melanocytic Tumors-Unmasking the Wolf in Sheep's Clothing? Cancers (Basel) 2021; 13:cancers13071645. [PMID: 33915997 PMCID: PMC8036965 DOI: 10.3390/cancers13071645] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 01/09/2023] Open
Abstract
Simple Summary Amplification and overexpression of the SEC62 oncogene was reported in a variety of human cancers and was associated with poor prognosis as well as lymph node and distant metastases. In this study, SEC62 expression was analyzed in benign, borderline, and malignant melanocytic lesions of 209 patients. We found the highest expression in Spitz nevi, followed by melanoma metastases, primary melanoma, congenital nevi, and blue nevi. In melanoma patients, high Sec62 levels correlated with shorter overall and progression-free survival. Significantly higher Sec62 levels were found in melanomas with lymph node and distant metastases compared with those without. Taken together, these data suggest a relevant role of SEC62 as a metastasis-stimulating oncogene in melanoma development, which represents a promising therapeutic target. Abstract SEC62 oncogene located at chromosomal region 3q26 encodes for a transmembrane protein of the endoplasmic reticulum (ER) and is expressed at high levels in numerous human malignancies. SEC62 overexpression has been associated with worse prognosis and high risk for lymphatic and distant metastases in head and neck cancer, cervical cancer, hepatocellular cancer, and lung cancer. However, its role in the development and tumor biology of melanocytic lesions has not been investigated so far. An immunohistochemical study including 209 patients with melanocytic lesions (malignant melanoma (MM), n = 93; melanoma metastases (MET), n = 28; Spitz nevi (SN), n = 29; blue nevi (BN), n = 21; congenital nevi (CN), n = 38) was conducted and SEC62 expression was correlated with clinical data including patient survival and histopathological characteristics. SN showed the highest SEC62 expression levels followed by MET, MM, CN, and BN. High SEC62 expression correlated with a shorter overall and progression-free survival in MM patients. Additionally, high Sec62 levels correlated significantly with higher tumor size (T stage), the presence of tumor ulceration, and the presence of lymph node as well as distant metastases. Strikingly, SEC62 expression showed a strong correlation with Clark level. Taken together, these data demonstrate that SEC62 is a promising prognostic marker in MM and has the potential to predict biological behavior and clinical aggressiveness of melanocytic lesions.
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Affiliation(s)
- Cornelia S. L. Müller
- Department of Dermatology, Venerology and Allergology, Saarland University Medical Center, D-66421 Homburg, Germany; (C.S.L.M.); (C.P.); (M.W.)
| | - Claudia Pföhler
- Department of Dermatology, Venerology and Allergology, Saarland University Medical Center, D-66421 Homburg, Germany; (C.S.L.M.); (C.P.); (M.W.)
| | - Maria Wahl
- Department of Dermatology, Venerology and Allergology, Saarland University Medical Center, D-66421 Homburg, Germany; (C.S.L.M.); (C.P.); (M.W.)
| | - Florian Bochen
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, D-66421 Homburg, Germany; (F.B.); (S.K.); (J.P.K.); (A.B.); (B.S.)
| | - Sandrina Körner
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, D-66421 Homburg, Germany; (F.B.); (S.K.); (J.P.K.); (A.B.); (B.S.)
| | - Jan Philipp Kühn
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, D-66421 Homburg, Germany; (F.B.); (S.K.); (J.P.K.); (A.B.); (B.S.)
| | - Alessandro Bozzato
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, D-66421 Homburg, Germany; (F.B.); (S.K.); (J.P.K.); (A.B.); (B.S.)
| | - Bernhard Schick
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, D-66421 Homburg, Germany; (F.B.); (S.K.); (J.P.K.); (A.B.); (B.S.)
| | - Maximilian Linxweiler
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, D-66421 Homburg, Germany; (F.B.); (S.K.); (J.P.K.); (A.B.); (B.S.)
- Correspondence: ; Tel.: +49-6841-162-2928
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Heimann L, Carlein C, Sorg K, Diller R, Langenbucher A, Schick B, Wenzel GI. Wavelength-specific optoacoustic-induced vibrations of the guinea pig tympanic membrane. J Biomed Opt 2021; 26:JBO-200335R. [PMID: 33675190 PMCID: PMC7934890 DOI: 10.1117/1.jbo.26.3.038001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 01/13/2021] [Indexed: 06/12/2023]
Abstract
SIGNIFICANCE Optoacoustic-induced vibrations of the hearing organ can potentially be used for a hearing device. To increase the efficiency of such a hearing device, the conversion of the light energy into vibration energy within each type of irradiated tissue has to be optimized. AIM To analyze the wavelength-dependency of optoacoustic-induced vibrations within the tympanic membrane (TM), and to define the most efficient and best-suited optical stimulation parameters for a novel auditory prosthesis. APPROACH Single nanosecond laser pulses, continuously tunable in a range of visible to near-infrared, were used to excite the guinea pig TM. The induced vibrations of the hearing organ were recorded at the malleus using a laser Doppler vibrometer. RESULTS Our results indicate a strong wavelength-dependency of the vibration's amplitude correlating with the superposition of the absorption spectra of the different specific tissue components. CONCLUSIONS We investigated the spectrum of the vibrations of the hearing organ that were induced optoacoustically within a biological membrane embedded in air, in an animal model. First applications for these results can be envisioned for the optical stimulation of the peripheral hearing organ as well as for research purposes.
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Affiliation(s)
- Larissa Heimann
- Saarland University, Medical Center, Department of Otolaryngology, Homburg, Germany
| | - Christopher Carlein
- University of Kaiserslautern, Department of Physics, Kaiserslautern, Germany
| | - Katharina Sorg
- Saarland University, Medical Center, Department of Otolaryngology, Homburg, Germany
| | - Rolf Diller
- University of Kaiserslautern, Department of Physics, Kaiserslautern, Germany
| | - Achim Langenbucher
- Saarland University, Medical Center, Department of Experimental Ophthalmology, Homburg, Germany
| | - Bernhard Schick
- Saarland University, Medical Center, Department of Otolaryngology, Homburg, Germany
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Abstract
CLINICAL/METHODICAL ISSUE Laryngeal cancer is the third most common malignancy in the head and neck region. Endoscopic laryngoscopy with assessment of vocal fold function, microlaryngoscopy with biopsy and computed tomography (CT)/magnetic resonance imaging (MRI) remain the cornerstones of diagnostic workup. Thus, in the context of therapy planning, consideration of individual functional and socioeconomic aspects is of major importance. STANDARD RADIOLOGICAL METHODS Due to the short acquisition time and the possibility to perform functional maneuvers, CT is the tool of choice. MRI allows better soft tissue differentiation, but is more susceptible to movement artifacts and is complicated by disease-specific symptoms. The choice of examination method therefore depends on the patient's physical resilience. PERFORMANCE Depending on the study, the information on the sensitivity of CT with regard to the question of cartilage infiltration varies between 62 and 87% with a specificity between 75 and 98%. For MRI, sensitivity between 64 and 95% and specificity between 56 and 88% are stated. ACHIEVEMENTS The synthesis of the findings from endoscopy, biopsy and imaging is prerequisite for initiation of stage-appropriate treatment. For image interpretation, knowledge of the anatomical landmarks is essential. However, the assessment of posttherapeutic changes also poses a challenge for the radiologist. PRACTICAL RECOMMENDATIONS Regular interdisciplinary dialogue between radiologists, otorhinolaryngologists and radiotherapists in the context of primary diagnostics, therapy planning and aftercare is essential.
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Affiliation(s)
- A Bozzato
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes, Kirrbergerstraße Gebäude 6, 66421, Homburg, Deutschland
| | - L Pillong
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes, Kirrbergerstraße Gebäude 6, 66421, Homburg, Deutschland.
| | - B Schick
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes, Kirrbergerstraße Gebäude 6, 66421, Homburg, Deutschland
| | - M M Lell
- Institut für Radiologie und Nuklearmedizin, Klinikum Nürnberg, Paracelsus Medical University, Nürnberg, Deutschland
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Takacs F, Radosa J, Bochen F, Juhasz-Böss I, Solomayer EF, Bohle R, Breitbach GP, Schick B, Linxweiler M. Sec62/Ki67- und p16/Ki67 immunzytochemische Doppelfärbungen in der Vulvazytologie zur Identifizierung von intraepithelialer Neoplasien und Vulvakarzinom: eine Pilotstudie. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718093] [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)
- F.Z Takacs
- Universität des Saarlandes, Klinik für Frauenheilkunde und Geburtshilfe
| | - J.C Radosa
- Universität des Saarlandes, Klinik für Frauenheilkunde und Geburtshilfe
| | - F Bochen
- Universität des Saarlandes, Klinik für Hals-, Nasen- und Ohrenheilkunde
| | - I Juhasz-Böss
- Universität des Saarlandes, Klinik für Frauenheilkunde und Geburtshilfe
| | - E.-F Solomayer
- Universität des Saarlandes, Klinik für Frauenheilkunde und Geburtshilfe
| | - R.M Bohle
- Universität des Saarlandes, Institut für Allgemeine und Spezielle Pathologie
| | - G.-P Breitbach
- Universität des Saarlandes, Klinik für Frauenheilkunde und Geburtshilfe
| | - B Schick
- Universität des Saarlandes, Klinik für Hals-, Nasen- und Ohrenheilkunde
| | - M Linxweiler
- Universität des Saarlandes, Klinik für Hals-, Nasen- und Ohrenheilkunde
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Takacs F, Radosa J, Bohle R, Bochen F, Juhasz-Böss I, Solomayer EF, Schick B, Linxweiler M. Sec62/Ki67 Doppelfärbung in zervikalen Dünnschichtzytologieproben: ein neuer Marker für hochgradigen plattenepithelialen Dysplasien. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718092] [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)
- F.Z Takacs
- Universität des Saarlandes, Klinik für Frauenheilkunde und Geburtshilfe
| | - J.C Radosa
- Universität des Saarlandes, Klinik für Frauenheilkunde und Geburtshilfe
| | - R.M Bohle
- Universität des Saarlandes, Institut für Allgemeine und Spezielle Pathologie
| | - F Bochen
- Universität des Saarlandes, Klinik für Hals-, Nasen- und Ohrenheilkunde
| | - I Juhasz-Böss
- Universität des Saarlandes, Klinik für Frauenheilkunde und Geburtshilfe
| | - E.-F Solomayer
- Universität des Saarlandes, Klinik für Frauenheilkunde und Geburtshilfe
| | - B Schick
- Universität des Saarlandes, Klinik für Hals-, Nasen- und Ohrenheilkunde
| | - M Linxweiler
- Universität des Saarlandes, Klinik für Hals-, Nasen- und Ohrenheilkunde
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Linxweiler M, Pillong L, Kopanja D, Kühn JP, Wagenpfeil S, Radosa JC, Wang J, Morris LGT, Al Kadah B, Bochen F, Körner S, Schick B. Augmented reality-enhanced navigation in endoscopic sinus surgery: A prospective, randomized, controlled clinical trial. Laryngoscope Investig Otolaryngol 2020; 5:621-629. [PMID: 32864433 PMCID: PMC7444769 DOI: 10.1002/lio2.436] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/11/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Endoscopic sinus surgery represents the gold standard for surgical treatment of chronic sinus diseases. Thereby, navigation systems can be of distinct use. In our study, we tested the recently developed KARL STORZ NAV1 SinusTracker navigation software that incorporates elements of augmented reality (AR) to provide a better preoperative planning and guidance during the surgical procedure. METHODS One hundred patients with chronic sinus disease were operated on using either a conventional navigation software (n = 52, non-AR, control group) or a navigation software incorporating AR elements (n = 48, AR, intervention group). Incidence of postoperative complications, duration of surgery, surgeon-reported benefit from the navigation system and patient-reported postoperative rehabilitation were assessed. RESULTS The surgeons reported a higher benefit during surgery, used the navigation system for more surgical steps and spent longer time with preoperative image analysis when using the AR system as compared with the non-AR system. No significant differences were seen in terms of postoperative complications, target registration error, operation time and postoperative rehabilitation. CONCLUSION The AR enhanced navigation software shows a high acceptance by sinus surgeons in different stages of surgical training and offers potential benefits during surgery without affecting the duration of the operation or the incidence of postoperative complications. LEVEL OF EVIDENCE 1b.
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Affiliation(s)
- Maximilian Linxweiler
- Department of Otorhinolaryngology, Head and Neck SurgerySaarland University Medical CentreHomburgGermany
| | - Lukas Pillong
- Department of Otorhinolaryngology, Head and Neck SurgerySaarland University Medical CentreHomburgGermany
| | - Dragan Kopanja
- Department of Otorhinolaryngology, Head and Neck SurgerySaarland University Medical CentreHomburgGermany
| | - Jan P. Kühn
- Department of Otorhinolaryngology, Head and Neck SurgerySaarland University Medical CentreHomburgGermany
| | - Stefan Wagenpfeil
- Institute of Medical Biometry, Epidemiology and Medical InformaticsSaarland University Medical CentreHomburgGermany
| | - Julia C. Radosa
- Department of Gynecology, Obstetrics and Reproductive MedicineSaarland University Medical CentreHomburgGermany
| | - Jingming Wang
- Human Oncology and Pathogenesis ProgramMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Luc G. T. Morris
- Immunogenomics and Precision Oncology PlatformMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
- Department of SurgeryMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Basel Al Kadah
- Department of OtorhinolaryngologyBethanien HospitalPlauenGermany
| | - Florian Bochen
- Department of Otorhinolaryngology, Head and Neck SurgerySaarland University Medical CentreHomburgGermany
| | - Sandrina Körner
- Department of Otorhinolaryngology, Head and Neck SurgerySaarland University Medical CentreHomburgGermany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Head and Neck SurgerySaarland University Medical CentreHomburgGermany
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Pillong L, Stahn P, Hinsberger M, Sorg K, Schick B, Wenzel GI. Cytotoxicity studies of an optoacoustic stimulation strategy for the development of laser-based hearing aids. J Biomed Opt 2020; 25:1-15. [PMID: 32578405 PMCID: PMC7310877 DOI: 10.1117/1.jbo.25.6.068002] [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] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 06/05/2020] [Indexed: 06/11/2023]
Abstract
SIGNIFICANCE Worldwide, ∼460 million people suffer from disabling hearing impairment. Many of these patients are still not sufficiently supplied with currently available auditory technologies. Optical stimulation of the hearing organ offers a promising alternative for a new generation of auditory prostheses. AIM To assess the biocompatibility margins of our laser pulse amplitude strategy in vitro, we designed a protocol and present the effects on normal human dermal fibroblasts, human chondrocytes, and human osteoblasts. APPROACH Laser pulses of 532 nm were applied over 120 s using our laser pulse amplitude modulation strategy. We then assessed cell viability and cytotoxicity through fluorescence staining and quantitative polymerase chain reaction-analysis regarding 84 key player-genes for cytotoxicity and stress response. RESULTS The first in vitro biocompatibility margins for our stimulation parameters applied to cells of the peripheral hearing organ were between 200 and 223 mW (3348 J/cm2). After irradiation with a subphototoxic laser power of 199 mW (2988 J/cm2), only the fibroblasts showed a significant upregulation of GADD45G. CONCLUSION Further studies are underway to optimize parameters for the optoacoustic stimulation of the auditory system. Our protocol and results on laser-tissue interactions can be useful for translational laser applications in various other irradiated biological tissues.
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Affiliation(s)
- Lukas Pillong
- Saarland University, Department of Otorhinolaryngology, Faculty of Medicine, Homburg, Germany
| | - Patricia Stahn
- Saarland University, Department of Otorhinolaryngology, Faculty of Medicine, Homburg, Germany
| | - Marius Hinsberger
- Saarland University, Department of Otorhinolaryngology, Faculty of Medicine, Homburg, Germany
| | - Katharina Sorg
- Saarland University, Department of Otorhinolaryngology, Faculty of Medicine, Homburg, Germany
| | - Bernhard Schick
- Saarland University, Department of Otorhinolaryngology, Faculty of Medicine, Homburg, Germany
| | - Gentiana I. Wenzel
- Saarland University, Department of Otorhinolaryngology, Faculty of Medicine, Homburg, Germany
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Kulas P, Seidel M, Bozzato A, Schick B, Sessler DI, Kreuer S, Hüppe T. Volatile organic compounds in head and neck squamous cell carcinoma-An in vitro pilot study. Biomed Chromatogr 2020; 34:e4811. [PMID: 32059060 DOI: 10.1002/bmc.4811] [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: 09/22/2019] [Revised: 02/02/2020] [Accepted: 02/11/2020] [Indexed: 11/07/2022]
Abstract
Owing to the lack of specific symptoms, diagnosis of head and neck squamous cell carcinoma (HNSCC) may be delayed. We evaluated volatile organic compounds in tumor samples from patients suffering from HNSCC and tested the hypothesis that there is a characteristic altered composition in the headspace of HNSCC compared with control samples from the same patient with normal squamous epithelium. These results provide the basis for future noninvasive breath analysis in HNSCC. Headspace air of suspected tumor and contralateral control samples in 20 patients were analyzed using ion-mobility spectrometry. Squamous cell carcinoma was diagnosed in 16 patients. In total, we observed 93 different signals in headspace measurements. Squamous cell carcinomas revealed significantly higher levels of volatile cyclohexanol (0.54 ppbv , 25th to 75th percentiles 0.35-0.86) compared with healthy squamous epithelium (0.24 ppbv , 25th to 75th percentiles 0.12-0.3; p < 0.001). In conclusion, head and neck squamous cell carcinoma emitted significantly higher levels of volatile cyclohexanol in headspace compared with normal squamous epithelium. These findings form the basis for future breath analysis for diagnosis, therapy control and the follow-up of HNSSC to improve therapy and aftercare.
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Affiliation(s)
- Philipp Kulas
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Homburg (Saar), Germany
| | - Martin Seidel
- Center of Breath Research, Department of Anesthesiology, Intensive Care and Pain Therapy, Saarland University Medical Center, Homburg (Saar), Germany
| | - Alessandro Bozzato
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Homburg (Saar), Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Homburg (Saar), Germany
| | - Daniel I Sessler
- Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Sascha Kreuer
- Center of Breath Research, Department of Anesthesiology, Intensive Care and Pain Therapy, Saarland University Medical Center, Homburg (Saar), Germany
| | - Tobias Hüppe
- Center of Breath Research, Department of Anesthesiology, Intensive Care and Pain Therapy, Saarland University Medical Center, Homburg (Saar), Germany
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Fehling MK, Grosch F, Schuster ME, Schick B, Lohscheller J. Fully automatic segmentation of glottis and vocal folds in endoscopic laryngeal high-speed videos using a deep Convolutional LSTM Network. PLoS One 2020; 15:e0227791. [PMID: 32040514 PMCID: PMC7010264 DOI: 10.1371/journal.pone.0227791] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 12/25/2019] [Indexed: 01/22/2023] Open
Abstract
The objective investigation of the dynamic properties of vocal fold vibrations demands the recording and further quantitative analysis of laryngeal high-speed video (HSV). Quantification of the vocal fold vibration patterns requires as a first step the segmentation of the glottal area within each video frame from which the vibrating edges of the vocal folds are usually derived. Consequently, the outcome of any further vibration analysis depends on the quality of this initial segmentation process. In this work we propose for the first time a procedure to fully automatically segment not only the time-varying glottal area but also the vocal fold tissue directly from laryngeal high-speed video (HSV) using a deep Convolutional Neural Network (CNN) approach. Eighteen different Convolutional Neural Network (CNN) network configurations were trained and evaluated on totally 13,000 high-speed video (HSV) frames obtained from 56 healthy and 74 pathologic subjects. The segmentation quality of the best performing Convolutional Neural Network (CNN) model, which uses Long Short-Term Memory (LSTM) cells to take also the temporal context into account, was intensely investigated on 15 test video sequences comprising 100 consecutive images each. As performance measures the Dice Coefficient (DC) as well as the precisions of four anatomical landmark positions were used. Over all test data a mean Dice Coefficient (DC) of 0.85 was obtained for the glottis and 0.91 and 0.90 for the right and left vocal fold (VF) respectively. The grand average precision of the identified landmarks amounts 2.2 pixels and is in the same range as comparable manual expert segmentations which can be regarded as Gold Standard. The method proposed here requires no user interaction and overcomes the limitations of current semiautomatic or computational expensive approaches. Thus, it allows also for the analysis of long high-speed video (HSV)-sequences and holds the promise to facilitate the objective analysis of vocal fold vibrations in clinical routine. The here used dataset including the ground truth will be provided freely for all scientific groups to allow a quantitative benchmarking of segmentation approaches in future.
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Affiliation(s)
- Mona Kirstin Fehling
- Department of Computer Science, Trier University of Applied Sciences, Schneidershof, Trier, Germany
| | - Fabian Grosch
- Department of Computer Science, Trier University of Applied Sciences, Schneidershof, Trier, Germany
| | - Maria Elke Schuster
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Munich, Campus Grosshadern, München, Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Saarland University Hospital, Homburg/Saar, Germany
| | - Jörg Lohscheller
- Department of Computer Science, Trier University of Applied Sciences, Schneidershof, Trier, Germany
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42
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Sorg K, Stahn P, Pillong L, Hinsberger MP, Heimann L, Foth HJ, Schick B, Wenzel GI. First biocompatibility margins for optical stimulation at the eardrum via 532-nm laser pulses in a mouse model. J Biomed Opt 2019; 24:1-10. [PMID: 31436071 PMCID: PMC6983485 DOI: 10.1117/1.jbo.24.8.085003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 07/29/2019] [Indexed: 06/10/2023]
Abstract
Hearing impairment affects ∼460 million people worldwide. Conservative therapies, such as hearing aids, bone conduction systems, and middle ear implants, do not always sufficiently compensate for this deficit. The optical stimulation is currently under investigation as an alternative stimulation strategy for the activation of the hearing system. To assess the biocompatibility margins of this emerging technology, we established a method applicable in whole-mount preparations of murine tympanic membranes (TM). We irradiated the TM of anesthetized mice with 532-nm laser pulses at an average power of 50, 89, 99, and 125 mW at two different locations of the TM and monitored the hearing function with auditory brainstem responses. Laser-power-dependent negative side effects to the TM were observed at power levels exceeding 89 mW. Although we did not find any significant negative effects of optical stimulation on the hearing function in these mice, based on the histology results further studies are necessary for optimization of the used parameters.
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Affiliation(s)
- Katharina Sorg
- Saarland University, Department of Otolaryngology, Faculty of Medicine, Homburg, Germany
| | - Patricia Stahn
- Saarland University, Department of Otolaryngology, Faculty of Medicine, Homburg, Germany
| | - Lukas Pillong
- Saarland University, Department of Otolaryngology, Faculty of Medicine, Homburg, Germany
| | - Marius P. Hinsberger
- Saarland University, Department of Otolaryngology, Faculty of Medicine, Homburg, Germany
| | - Larissa Heimann
- Saarland University, Department of Otolaryngology, Faculty of Medicine, Homburg, Germany
| | - Hans-Jochen Foth
- University of Kaiserslautern, Department of Physics, Kaiserslautern, Germany
| | - Bernhard Schick
- Saarland University, Department of Otolaryngology, Faculty of Medicine, Homburg, Germany
| | - Gentiana I. Wenzel
- Saarland University, Department of Otolaryngology, Faculty of Medicine, Homburg, Germany
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Eckrich S, Hecker D, Sorg K, Blum K, Fischer K, Münkner S, Wenzel G, Schick B, Engel J. Cochlea-Specific Deletion of Ca v1.3 Calcium Channels Arrests Inner Hair Cell Differentiation and Unravels Pitfalls of Conditional Mouse Models. Front Cell Neurosci 2019; 13:225. [PMID: 31178698 PMCID: PMC6538774 DOI: 10.3389/fncel.2019.00225] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 05/03/2019] [Indexed: 12/29/2022] Open
Abstract
Inner hair cell (IHC) Cav1.3 Ca2+ channels are multifunctional channels mediating Ca2+ influx for exocytosis at ribbon synapses, the generation of Ca2+ action potentials in pre-hearing IHCs and gene expression. IHCs of deaf systemic Cav1.3-deficient (Cav1.3-/-) mice stay immature because they fail to up-regulate voltage- and Ca2+-activated K+ (BK) channels but persistently express small conductance Ca2+-activated K+ (SK2) channels. In pre-hearing wildtype mice, cholinergic neurons from the superior olivary complex (SOC) exert efferent inhibition onto spontaneously active immature IHCs by activating their SK2 channels. Because Cav1.3 plays an important role for survival, health and function of SOC neurons, SK2 channel persistence and lack of BK channels in systemic Cav1.3-/- IHCs may result from malfunctioning neurons of the SOC. Here we analyze cochlea-specific Cav1.3 knockout mice with green fluorescent protein (GFP) switch reporter function, Pax2::cre;Cacna1d-eGFPflex/flexand Pax2::cre;Cacna1d-eGFPflex/-. Profound hearing loss, lack of BK channels and persistence of SK2 channels in Pax2::cre;Cacna1d-eGFPflex/- mice recapitulated the phenotype of systemic Cav1.3-/- mice, indicating that in wildtype mice, regulation of SK2 and BK channel expression is independent of Cav1.3 expression in SOC neurons. In addition, we noticed dose-dependent GFP toxicity leading to death of basal coil IHCs of Pax2::cre;Cacna1d-eGFPflex/flex mice, likely because of high GFP concentration and small repair capacity. This and the slower time course of Pax2-driven Cre recombinase in switching two rather than one Cacna1d-eGFPflex allele lead us to study Pax2::cre;Cacna1d-eGFPflex/- mice. Notably, control Cacna1d-eGFPflex/- IHCs showed a significant reduction in Cav1.3 channel cluster sizes and currents, suggesting that the intronic construct interfered with gene translation or splicing. These pitfalls are likely to be a frequent problem of many genetically modified mice with complex or multiple gene-targeting constructs or fluorescent proteins. Great caution and appropriate controls are therefore required.
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Affiliation(s)
- Stephanie Eckrich
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
| | - Dietmar Hecker
- Department of Otorhinolaryngology, Saarland University, Homburg, Germany
| | - Katharina Sorg
- Department of Otorhinolaryngology, Saarland University, Homburg, Germany
| | - Kerstin Blum
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
| | - Kerstin Fischer
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
| | - Stefan Münkner
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
| | - Gentiana Wenzel
- Department of Otorhinolaryngology, Saarland University, Homburg, Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Saarland University, Homburg, Germany
| | - Jutta Engel
- Department of Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
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Abstract
An infantile sinunasal hemangiopericytoma as a variant of infantile myofibroma is a rare finding. The observation of a sinunasal, infantile hemangiopericytoma affecting the anterior skull base and ethmoid bone in a female infant is presented. Chromosomal gains (6q14q16.2 und 18q22qter) as well as chromosomal losses (5q33.3q35.2, 10p11.2p12.2, 10q24.3q26.1, 15q23q25, 17p12pter and 22q11.2q13.2) were present. Endonasal tumor resection was achieved.
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Affiliation(s)
- A Heyduck
- Klinikum für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum des Saarlandes, Kirrbergerstraße, 66421, Homburg/Saar, Deutschland.
| | - S Wemmert
- Klinikum für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum des Saarlandes, Kirrbergerstraße, 66421, Homburg/Saar, Deutschland
| | - I Leuschner
- Kindertumorregister, Sektion Kinderpathologie, Campus Kiel, Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland
| | - B Schick
- Klinikum für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum des Saarlandes, Kirrbergerstraße, 66421, Homburg/Saar, Deutschland
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45
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Stahn P, Lim HH, Hinsberger MP, Sorg K, Pillong L, Kannengießer M, Schreiter C, Foth HJ, Langenbucher A, Schick B, Wenzel GI. Frequency-specific activation of the peripheral auditory system using optoacoustic laser stimulation. Sci Rep 2019; 9:4171. [PMID: 30862850 PMCID: PMC6414650 DOI: 10.1038/s41598-019-40860-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 02/22/2019] [Indexed: 11/09/2022] Open
Abstract
Hearing impairment is one of the most common sensory deficits in humans. Hearing aids are helpful to patients but can have poor sound quality or transmission due to insufficient output or acoustic feedback, such as for high frequencies. Implantable devices partially overcome these issues but require surgery with limited locations for device attachment. Here, we investigate a new optoacoustic approach to vibrate the hearing organ with laser stimulation to improve frequency bandwidth, not requiring attachment to specific vibratory structures, and potentially reduce acoustic feedback. We developed a laser pulse modulation strategy and simulated its response at the umbo (1-10 kHz) based on a convolution-based model. We achieved frequency-specific activation in which non-contact laser stimulation of the umbo, as well as within the middle ear at the round window and otic capsule, induced precise shifts in the maximal vibratory response of the umbo and neural activation within the inferior colliculus of guinea pigs, corresponding to the targeted, modelled and then stimulated frequency. There was also no acoustic feedback detected from laser stimulation with our experimental setup. These findings open up the potential for using a convolution-based optoacoustic approach as a new type of laser hearing aid or middle ear implant.
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Affiliation(s)
- Patricia Stahn
- Saarland University, Faculty of Medicine, Department of Otolaryngology, Kirrbergerstr. 100, 66421, Homburg, Germany.
| | - Hubert H Lim
- University of Minnesota, Department of Biomedical Engineering, Department of Otolaryngology, Minnesota, USA
| | - Marius P Hinsberger
- Saarland University, Faculty of Medicine, Department of Otolaryngology, Kirrbergerstr. 100, 66421, Homburg, Germany
| | - Katharina Sorg
- Saarland University, Faculty of Medicine, Department of Otolaryngology, Kirrbergerstr. 100, 66421, Homburg, Germany
| | - Lukas Pillong
- Saarland University, Faculty of Medicine, Department of Otolaryngology, Kirrbergerstr. 100, 66421, Homburg, Germany
| | - Marc Kannengießer
- Saarland University, Faculty of Medicine, Department of Otolaryngology, Kirrbergerstr. 100, 66421, Homburg, Germany
- Saarland University, Experimental Ophthalmology, Homburg, Germany
| | - Cathleen Schreiter
- Saarland University, Faculty of Medicine, Department of Otolaryngology, Kirrbergerstr. 100, 66421, Homburg, Germany
| | - Hans-Jochen Foth
- Technische Universität Kaiserslautern, Department of Physics, Kaiserslautern, Germany
| | | | - Bernhard Schick
- Saarland University, Faculty of Medicine, Department of Otolaryngology, Kirrbergerstr. 100, 66421, Homburg, Germany
| | - Gentiana I Wenzel
- Saarland University, Faculty of Medicine, Department of Otolaryngology, Kirrbergerstr. 100, 66421, Homburg, Germany.
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46
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Müller CSL, Kreie L, Bochen F, Pfuhl T, Smola S, Gräber S, Vogt T, Schick B, Linxweiler M. Expression of 3q oncogene SEC62 in atypical fibroxanthoma-immunohistochemical analysis of 41 cases and correlation with clinical, viral and histopathologic features. Oncol Lett 2018; 17:1768-1776. [PMID: 30675236 PMCID: PMC6341582 DOI: 10.3892/ol.2018.9767] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 10/26/2018] [Indexed: 12/30/2022] Open
Abstract
Atypical fibroxanthoma (AFX) is a rare mesenchymal tumor with predominance in older male patients located mainly in chronically UV-exposed skin. Differentiation from clinically more aggressive pleomorphic dermal sarcoma (PDS) is still under debate and immunohistochemical markers are not available yet. An immunohistochemical study, including 41 cases of AFX was conducted to investigate the expression of 3q encoded oncogene SEC62 in AFX and determine the associations with histomorphologic, clinical and viral parameters. Our cohort displayed a mean of 79.9 years at the onset of the disease. In total, 90.2% (37/41) AFXs were located in the head and neck area, whereas, four were located at the extremities (9.7%). Tumor diameter ranged between 0.06 and 40 cm2 with a mean of 5.7 cm2. SEC62 expression was markedly increased in lesional tissue compared with the adjacent healthy squamous epithelium. We found significantly higher expression of SEC62 in cases of AFX with tumor necrosis. Tendency of higher Sec62-IRS-scores were found for tumors with higher Clark levels and a tumor size >5 cm2. Sec62 is involved in endoplasmic reticulum stress tolerance and cell migration, and has been identified as a novel prognostic marker for non-small cell lung cancer as well as head and neck squamous cell carcinoma. For the first time, to the best of our knowledge, we suggest a role of 3q oncogene SEC62 in AFX and discuss a potential prognostic relevance in cases of disputable AFX with unfavorable histomorphologic features and may initiate a discussion on Sec62 serving as discriminating marker between AFX and PDS.
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Affiliation(s)
- Cornelia S L Müller
- Department of Dermatology, Venereology and Allergology, Saarland University Medical Center, D-66421 Homburg, Germany
| | - Léa Kreie
- Department of Dermatology, Venereology and Allergology, Saarland University Medical Center, D-66421 Homburg, Germany
| | - Florian Bochen
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, D-66421 Homburg, Germany
| | - Thorsten Pfuhl
- Institute of Virology, Saarland University Medical Center, D-66421 Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, Saarland University Medical Center, D-66421 Homburg, Germany
| | - Stefan Gräber
- Institute of Biometry, Epidemiology and Medical Informatics, Saarland University Medical Center, D-66421 Homburg, Germany
| | - Thomas Vogt
- Department of Dermatology, Venereology and Allergology, Saarland University Medical Center, D-66421 Homburg, Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, D-66421 Homburg, Germany
| | - Maximilian Linxweiler
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, D-66421 Homburg, Germany
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Abstract
BACKGROUND Dysphagia is a common symptom reported by patients in various medical fields, raising the question of diagnosis. In addition to otorhinolaryngologic examination with a mirror, the current gold standards videofluoroscopy and fiber optic endoscopic evaluation of swallowing (FEES) are available. Ultrasound is frequently used in everyday clinical practice, although its application for swallowing diagnostics needs addressing. MATERIALS AND METHODS Between April 2012 and February 2014, 81 subjects (age 19-66 years) with no indication of a swallowing disorder were sonographically examined. The anatomic representation of swallowing structures was evaluated and videos of the cervical part of the esophagus during swallowing of different consistencies (saliva, water, jelly) were recorded and analyzed. In a pilot study, the examination was tested on 3 dysphagia patients. RESULTS The base of the tongue, the intralaryngeal structures, the cervical spine, and the thyroid glands were well visualized. Sonographic representation of the cervical esophagus section was particularly successful. Its length could be detected at 5.78 ± 1.66 cm, the diameter measured at 0.88 ± 0.10 cm. Sonographic inspection of the sinus piriformis was most difficult; it could not be seen in 39.5% of cases. Visualization of the sinus piriformis was better in cases of normal weight and age <25 years (odds ratios 5.6 and 11.3, respectively). In the examination of patients with a swallowing disorder, three different pathologies (Forestier's disease, esophageal stenosis, and motor neuron disease) were identified as the cause of complaints. CONCLUSION Sonography enables very good visualization of swallowing and evaluation of the cervical esophagus. Where available, the otorhinolaryngologist should consider ultrasound as a diagnostic option, as it enables repeated evaluation of swallowing and can complement previously available diagnostic tools.
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Affiliation(s)
- Laura S Grebe
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum des Saarlandes, Kirrberger Straße, 66421, Homburg/Saar, Deutschland.
| | - G Wolf
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum des Saarlandes, Kirrberger Straße, 66421, Homburg/Saar, Deutschland
| | - B Schick
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum des Saarlandes, Kirrberger Straße, 66421, Homburg/Saar, Deutschland
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Schacht SAL, Stahn P, Hinsberger M, Schick B, Wenzel GI. Laser-induced tissue remodeling within the tympanic membrane. J Biomed Opt 2018; 23:1-8. [PMID: 30499262 DOI: 10.1117/1.jbo.23.12.121614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 10/19/2018] [Indexed: 06/09/2023]
Abstract
The tympanic membrane (TM) separates the outer ear from the tympanic cavity. Repeated pathologies can permanently decrease its tension, inducing conductive hearing loss and adhesive processes up to cholesteatoma. The current main therapy is its surgical reconstruction. Even though lasers have been proposed to tighten atrophic TMs, details of this effect, specifically histological analyses, are missing. We therefore used laser pulses to induce TM collagen remodeling in an animal model to compare the histological and electrophysiological effects of different applied laser intensities before entering clinical studies. We irradiated Fuchsin-stained areas of the TM in anesthetized mice with 532-nm laser-pulses of 10 mW for 30 s (0.3 J), 25 mW for 30 s (0.75 J) or 50 mW for 30 s (1.5 J) monitoring hearing with auditory brainstem responses (ABRs). The mice were sacrificed after 2 to 8 weeks and histologically analyzed. An increase in the TM thickness within the defined, stained, and irradiated areas could be observed after 4 weeks. Polarized light microscopy and transmission electron microscopy demonstrated the tissue volume increase majorly due to new collagen-fibrils. Directly after irradiation, ABR thresholds did not increase. We herein demonstrate a controlled laser-induced collagen remodeling within defined areas of the TM. This method might be the prophylactic solution for chronic inflammatory ear pathologies related to decreased TM tension.
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Affiliation(s)
- Sophie A L Schacht
- University of Saarland, Department of Otorhinolaryngology, Homburg, Germany
| | - Patricia Stahn
- University of Saarland, Department of Otorhinolaryngology, Homburg, Germany
| | - Marius Hinsberger
- University of Saarland, Department of Otorhinolaryngology, Homburg, Germany
| | - Bernhard Schick
- University of Saarland, Department of Otorhinolaryngology, Homburg, Germany
| | - Gentiana I Wenzel
- University of Saarland, Department of Otorhinolaryngology, Homburg, Germany
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49
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Al Kadah B, Naumann A, Schneider M, Schick B, Linxweiler M, Papaspyrou G. Auricular reconstruction with polyethylene implants or silicone prosthesis: A single institution experience. J Craniomaxillofac Surg 2018; 46:2150-2156. [PMID: 30420151 DOI: 10.1016/j.jcms.2018.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/10/2018] [Accepted: 10/15/2018] [Indexed: 11/25/2022] Open
Abstract
Auricular reconstruction is usually necessary in patients with congenital malformations, after traumatic ear amputations or in cases of neoplastic ear disease. Thirty-nine patients who underwent an auricular reconstruction with either silicon prosthesis (21 patients) or porous polyethylene (18 patients) between 2002 and 2013 were retrospectively analyzed at a tertiary academic institution. A total of 25 male und 14 female patients were included in the study. In all, 43 implants were installed in 39 patients. An implant failure was not observed in any of the examined groups. An operative revision was necessary in 5 patients in the silicon prosthesis group (N = 21) and in 4 patients in the porous polyethylene group (N = 18). The most common side effect in the porous polyethylene group was the formation of retroauricular adhesions in 11.1 % by postoperative scaring, while in the silicone prosthesis group 71.4 % of the patients presented with skin reactions around the titanium implants. Our study shows that both techniques are valuable and should be offered to patients in cases of auricular reconstruction due to the low rate of severe complications and the good functional results of both techniques.
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Affiliation(s)
- Basel Al Kadah
- Department of Otorhinolaryngology, University Medical Centre, Homburg, Saar, Germany.
| | | | | | - Bernhard Schick
- Department of Otorhinolaryngology, University Medical Centre, Homburg, Saar, Germany
| | - Maximilian Linxweiler
- Department of Otorhinolaryngology, University Medical Centre, Homburg, Saar, Germany
| | - Giorgos Papaspyrou
- Department of Otorhinolaryngology, University Medical Centre, Homburg, Saar, Germany
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50
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Kasoha M, Takacs Z, Bohle RM, Schmidt G, Linxweiler M, Schick B, Juhasz-Böss I, Solomayer EF. Protein expression of SEC62 in triple-negative breast cancer. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671046] [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)
- M Kasoha
- University of Saarland, Department of Obstetrics, Gynecology and Reproductive Medicine, Homburg, Deutschland
| | - Z Takacs
- University of Saarland, Department of Obstetrics, Gynecology and Reproductive Medicine, Homburg, Deutschland
| | - RM Bohle
- University of Saarland, Institute for General and Special Pathology, Homburg, Deutschland
| | - G Schmidt
- University of Saarland, Department of Obstetrics, Gynecology and Reproductive Medicine, Homburg, Deutschland
| | - M Linxweiler
- University of Saarland, Department of Otorhinolaryngology, Homburg, Deutschland
| | - B Schick
- University of Saarland, Department of Otorhinolaryngology, Homburg, Deutschland
| | - I Juhasz-Böss
- University of Saarland, Department of Obstetrics, Gynecology and Reproductive Medicine, Homburg, Deutschland
| | - EF Solomayer
- University of Saarland, Department of Obstetrics, Gynecology and Reproductive Medicine, Homburg, Deutschland
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