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Szabó G, Bokor A, Fancsovits V, Madár I, Darici E, Pashkunova D, Arányi Z, Fintha A, Rigó JJ, Lipták L, Mázsár B, Hudelist G. Clinical and ultrasound characteristics of deep endometriosis affecting sacral plexus. Ultrasound Obstet Gynecol 2024. [PMID: 38315642 DOI: 10.1002/uog.27602] [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] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/03/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVES To describe sonomorphological changes and appearance of deep endometriosis (DE) affecting the nervous tissue of the sacral plexus (SP). METHODS This was a retrospective study of symptomatic female patients who underwent radical resection of histologically confirmed DE affecting the SP who had undergone preoperative transvaginal sonography (TVS). Between 2019 and 2023 lesions were described based on the terms and definitions of the International Deep Endometriosis Analysis (IDEA) group. DE affecting the SP was diagnosed on ultrasound by TVS, when sonographic criteria of DE were visualized in conjunction with fibers of the SP and the presence of related symptoms, so-called sacral radiculopathy. Clinical symptoms, ultrasound features and histological confirmation were analyzed for each patient included. RESULTS Twenty-seven patients with DE infiltrating the sacral plexus were identified in 2 contributing tertiary referral centers. Median age was 37 (range, 29-45) years and all of the patients were symptomatic and presented one or more of the following neurological symptoms: dysaesthesia in the ipsilateral lower extremity (n = 17), paraesthesia in the ipsilateral lower extremity (n = 10), chronic pelvic pain radiating in the ipsilateral lower extremity (n = 9), chronic pain radiating in the pudendal region (n = 8), weakness in the ipsilateral lower extremities (n = 3). All DE lesions affecting the SP were purely solid tumors in the posterior parametrium in direct contact with or infiltrating the S1 and/or S2 and/or S3 and/or S4 roots of the SP. The median of the largest diameter of the DE nodules was 35 mm and echogenicity of the DE nodules was in 86% (n=23) non-uniform. All but one of them contained hyperechoic areas. The shape of the lesions was in 89% (n=24)irregular. Only one lesion exhibited lobulated form, all other irregular lesion showed spiculated appearance. 74% (n=20) of the nodules gave an acoustic shadow, all of them internal. With color or power Doppler examination 78% (n=21) of the nodules showed no signal (Color Score 1). The remaining 22% (n=6) of the lesions manifested only a minimal color content (Color Score 2). According to pattern recognition, most DE nodules were a purely solid non-uniform hypoechoic nodule with hyperechoic areas, internal shadows and irregular spiculated contours and poorly vascularized at color/power Doppler examination. CONCLUSION The ultrasound finding of a parametrial unilateral solid non-uniform hypoechoic nodule with hyperechoic areas and possible internal shadowing as well as irregular spiculated contours demonstrating poor vascularization on Doppler examination in proximity or involving the structures of the SP reflects DE affecting these structures. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- G Szabó
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - A Bokor
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - V Fancsovits
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - I Madár
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - E Darici
- Brussels IVF, Center for Reproductive Medicine Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - D Pashkunova
- Department of Gynecology, Center for Endometriosis, Hospital St. John of God, Vienna, Austria
| | - Z Arányi
- Department of Neurology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - A Fintha
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - J Jr Rigó
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Department of Clinical Studies in Obstetrics and Gynecology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - L Lipták
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - B Mázsár
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - G Hudelist
- Department of Gynecology, Center for Endometriosis, Hospital St. John of God, Vienna, Austria
- Rudolfinerhaus Private Clinic and Campus, Vienna, Austria
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Stefano G, Condous G, Rolla M, Hudelist G, Ferrero S, Alcazar JL, Ajossa S, Bafort C, Van Schoubroeck D, Bourne T, Van den Bosch T, Singh SS, Abrao MS, Szabó G, Testa AC, Di Giovanni A, Fischerova D, Tomassetti C, Timmerman D. Addendum to the consensus opinion from the International Deep Endometriosis Analysis (IDEA) group: sonographic evaluation of the parametrium. Ultrasound Obstet Gynecol 2023. [PMID: 38057967 DOI: 10.1002/uog.27558] [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] [Received: 08/24/2023] [Revised: 11/24/2023] [Accepted: 11/30/2023] [Indexed: 12/08/2023]
Abstract
Preoperative sonographic staging in patients with suspected parametrial endometriosis is essential to plan the surgical intervention and to anticipate the need for a multidisciplinary approach, and hence optimize surgical outcome. The results of a recent metanalysis suggest that defining more accurately the ultrasonographic criteria of parametrial involvement in endometriosis is needed. The aim of this addendum to the IDEA-consensus is to highlight the sonographic characteristics of the parametrium and identify ultrasound techniques to diagnose deep endometriosis in this area. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- G Stefano
- Centro Integrato di Procreazione Medicalmente Assistita (PMA) e Diagnostica Ostetrico-Ginecologica, Azienda Ospedaliero Universitaria Cagliari-Policlinico Duilio Casula, Monserrato, Italy
- University of Cagliari, Cagliari, Italy
| | - G Condous
- Acute Gynaecology, Early Pregnancy and Advanced Endoscopy Surgery Unit, Sydney Medical School Nepean, Nepean Hospital, University of Sydney, Penrith, New South Wales, Australia
| | - M Rolla
- Department of Gynecology and Obstetrics of Parma, University of Parma, Parma, Italy
| | - G Hudelist
- Department of Gynecology, Center for Endometriosis, Hospital St John of God, Vienna, Austria
- Rudolfinerhaus Private Clinic and Campus, Vienna, Austria
| | - S Ferrero
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - J L Alcazar
- Department of Obstetrics and Gynecology, School of Medicine, Universidad de Navarra, Pamplona, Spain
| | - S Ajossa
- Centro Integrato di Procreazione Medicalmente Assistita (PMA) e Diagnostica Ostetrico-Ginecologica, Azienda Ospedaliero Universitaria-Policlinico Duilio Casula, Monserrato, Italy
| | - C Bafort
- Department of Obstetrics and Gynaecology, Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - D Van Schoubroeck
- Department of Obstetrics and Gynaecology, Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium
| | - T Bourne
- Queen Charlotte's and Chelsea Hospital, Imperial College, London, UK
| | - T Van den Bosch
- Department of Obstetrics and Gynecology, KU Leuven University Hospital, Leuven, Belgium
| | - S S Singh
- Department of Obstetrics and Gynecology, The Ottawa Hospital, Ottawa, Canada
| | - M S Abrao
- Gynecologic Division, BP-A Beneficencia Portuguesa de São Paulo, São Paulo, Brazil
- Disciplina de Ginecologia, Departamento de Obstetricia e Ginecologia, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - G Szabó
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - A C Testa
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Di Giovanni
- Endoscopica Malzoni, Center for Advanced Pelvic Surgery (Drs Giovanni), Avellino, Italy
| | - D Fischerova
- Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - C Tomassetti
- Department of Obstetrics and Gynaecology, Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - D Timmerman
- Department of Obstetrics and Gynaecology, Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
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Fischerova D, Santos G, Wong L, Yulzari V, Bennett RJ, Dundr P, Burgetova A, Barsa P, Szabó G, Sousa N, Scovazzi U, Cibula D. Imaging in gynecological disease (26): clinical and ultrasound characteristics of benign retroperitoneal pelvic peripheral-nerve-sheath tumors. Ultrasound Obstet Gynecol 2023; 62:727-738. [PMID: 37058402 DOI: 10.1002/uog.26223] [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] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/27/2023] [Accepted: 03/30/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE To describe the clinical and sonographic characteristics of benign, retroperitoneal, pelvic peripheral-nerve-sheath tumors (PNSTs). METHODS This was a retrospective study of patients with a benign, retroperitoneal, pelvic PNST who had undergone preoperative ultrasound examination at a single gynecologic oncology center between 1 January 2018 and 31 August 2022. All ultrasound images, videoclips and final histological specimens of benign PNSTs were reviewed side-by-side in order to: describe the ultrasound appearance of the tumors, using the terminology of the International Ovarian Tumor Analysis (IOTA), Morphological Uterus Sonographic Assessment (MUSA) and Vulvar International Tumor Analysis (VITA) groups, following a predefined ultrasound assessment form; describe their origin in relation to nerves and pelvic anatomy; and assess the association between their ultrasound features and histotopography. A review of the literature reporting benign, retroperitoneal, pelvic PNSTs with preoperative ultrasound examination was performed. RESULTS Five women (mean age, 53 years) with a benign, retroperitoneal, pelvic PNST were identified, four with a schwannoma and one with a neurofibroma, of which all were sporadic and solitary. All patients had good-quality ultrasound images and videoclips and final biopsy of surgically excised tumors, except one patient managed conservatively who had only a core needle biopsy. In all cases, the findings were incidental. The five PNSTs ranged in maximum diameter from 31 to 50 mm. All five PNSTs were solid, moderately vascular tumors, with non-uniform echogenicity, well-circumscribed by hyperechogenic epineurium and with no acoustic shadowing. Most of the masses were round (n = 4 (80%)), and contained small, irregular, anechoic, cystic areas (n = 3 (60%)) and hyperechogenic foci (n = 5 (100%)). In the woman with a schwannoma in whom surgery was not performed, follow-up over a 3-year period showed minimal growth (1.5 mm/year) of the mass. We also summarize the findings of 47 cases of benign retroperitoneal schwannoma and neurofibroma identified in a literature search. CONCLUSIONS On ultrasound examination, no imaging characteristics differentiate reliably between benign schwannomas and neurofibromas. Moreover, benign PNSTs show some similar features to malignant retroperitoneal tumors. They are solid lesions with intralesional blood vessels and show degenerative changes such as cystic areas and hyperechogenic foci. Therefore, ultrasound-guided biopsy may play a pivotal role in their diagnosis. If confirmed to be benign PNSTs, these tumors can be managed conservatively, with ultrasound surveillance. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- D Fischerova
- Gynecologic Oncology Center, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - G Santos
- Institute for Women's Health, The Medical City, Pasig City, Philippines
| | - L Wong
- Department of Obstetrics and Gynecology, Monash University and Monash Health, Clayton, Australia
| | - V Yulzari
- Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel
| | - R J Bennett
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - P Dundr
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - A Burgetova
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - P Barsa
- Department of Neurosurgery, Neurocenter, Regional Hospital Liberec, Liberec, Czech Republic
- Department of Neurosurgery and Neuro-oncology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Central Military Hospital, Prague, Czech Republic
| | - G Szabó
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - N Sousa
- Department of Gynecology and Obstetrics, Hospital de Braga, Braga, Portugal
| | - U Scovazzi
- Department of Gynecology and Obstetrics, Ospedale Policlinico San Martino and University of Genoa, Genova, Italy
| | - D Cibula
- Gynecologic Oncology Center, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
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Szabó G, Madár I, Hudelist G, Arányi Z, Turtóczki K, Rigó J, Ács N, Lipták L, Fancsovits V, Bokor A. Visualization of sacral nerve roots and sacral plexus on gynecological transvaginal ultrasound: feasibility study. Ultrasound Obstet Gynecol 2023; 62:290-299. [PMID: 36938682 DOI: 10.1002/uog.26204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 02/06/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To investigate the feasibility of identifying and measuring the normal sacral plexus (SP) on gynecological transvaginal ultrasound (TVS) examination. METHODS This was a prospective observational study conducted at a single tertiary gynecological referral center, including consecutive women undergoing TVS for various indications between November 2021 and January 2022. A standardized assessment of the pelvic organs was performed and the presence of any congenital or acquired uterine pathology or ovarian abnormality was recorded. Visualization of the right and left SP was attempted in all cases. The success rate and the time needed to identify the SP were recorded and measurements of the SP were made. RESULTS A total of 326 patients were included in the study. In all women, the SP was identified successfully on at least one side. SP were visualized bilaterally in 317 (97.2% (95% CI, 94.4-98.5%)) women. Only the right SP was seen in 3/326 (0.9% (95% CI, 0.2-2.7%)) and only the left in 6/326 (1.8% (95% CI, 0.6-4.0%)) (P = 0.5048). There was no significant difference in the median time required to visualize the right vs left SP (9.0 (interquartile range (IQR), 8.0-10.0) s vs 9.0 (IQR, 8.0-10.0) s; P = 0.0770). The median transverse diameter of the right SP was 15.0 (IQR, 14.2-15.6) mm and that of the left SP was 14.9 (IQR, 14.4-15.6) mm. CONCLUSIONS We describe a novel method which allows for the consistent and rapid identification of the SP on TVS. Integrating assessment of the SP into routine pelvic TVS may be helpful particularly for women suffering from deep endometriosis. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- G Szabó
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - I Madár
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - G Hudelist
- Department of Gynaecology, Center for Endometriosis, Hospital St John of God, Vienna, Austria
- Rudolfinerhaus Private Clinic and Campus, Vienna, Austria
| | - Z Arányi
- Department of Neurology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - K Turtóczki
- Department of Radiology, Medical Imaging Centre, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - J Rigó
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Department of Clinical Studies in Obstetrics and Gynaecology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - N Ács
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - L Lipták
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - V Fancsovits
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - A Bokor
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
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Saemann L, Hoorn F, Wächter K, Pohl S, Korkmaz-Icöz S, Wenzel F, Karck M, Simm A, Szabó G. Cytokine Adsorption During Ex-Vivo Blood Perfusion Improves Contractility and Modifies the Transcriptomic Profile of Donation after Circulatory Death Hearts. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1656] [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: 04/05/2023] Open
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Saemann L, Hoorn F, Wächter K, Pohl S, Korkmaz-Icöz S, Wenzel F, Karck M, Simm A, Szabó G. HTK-N Versus Del Nido Cardioplegia for Hypothermic Machine Perfusion of Donation after Circulatory Death Hearts: Comparison of Left-Ventricular Contractility and Transcriptomics. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1491] [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: 04/05/2023] Open
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Saemann L, Hoorn F, Georgevici A, Korkmaz-Icöz S, Veres G, Guo Y, Simm A, Karck M, Wenzel F, Szabó G. Crystalloid Machine Perfusion with the Novel HTK-N Preservation Solution Reduces Microvascular Dysfunction in Circulatory Death Hearts. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Nguyen L, Szabó G, Zsom T, Hitka G. Application of ethylene for ripening of 1-MCP treated pear after cold storage. AAlim 2022. [DOI: 10.1556/066.2021.00201] [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: 11/19/2022]
Abstract
Abstract
This work aimed to evaluate the effect of ethylene treatment on ripening of 1-MCP treated pear after 6 months of cold storage. Pear treated with gaseous 1-MCP at 625–650 ppb for 24 h at 0 °C was stored at 0 °C for 6 months with normal air, and treated groups were exposed to 100 ppm ethylene at 20 °C for 24 h. After that, samples were kept at 0, 10, and 15 °C for 2 weeks. Stiffness, chlorophyll fluorescence, ethylene and CO2 production of fruit were investigated during 2 weeks. Application of ethylene resumed the ripening of pear after long term storage. The results showed that fruit treated with ethylene achieved more homogeneous surface colour in comparison with non ethylene treated pears. In addition, the ethylene and carbon dioxide production of ethylene treated pears had higher values than that of control. The ethylene treatment could accelerate the softening of pear. Temperature also has significant effect on ripening during storage. This study found that ethylene treatment could accelerate the normal ripening of 1-MCP treated pears.
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Affiliation(s)
- L.L.P. Nguyen
- Institute of Food Science and Technology, Hungarian University of Agriculture and Life Sciences, H-1118, Budapest, Hungary
- Institute of Biotechnology and Food Technology, Industrial University of Ho Chi Minh City, 700000, Ho Chi Minh, Viet Nam
| | - G. Szabó
- Institute of Food Science and Technology, Hungarian University of Agriculture and Life Sciences, H-1118, Budapest, Hungary
| | - T. Zsom
- Institute of Food Science and Technology, Hungarian University of Agriculture and Life Sciences, H-1118, Budapest, Hungary
| | - G. Hitka
- Institute of Food Science and Technology, Hungarian University of Agriculture and Life Sciences, H-1118, Budapest, Hungary
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Montanari E, Bokor A, Szabó G, Kondo W, Trippia CH, Malzoni M, Di Giovanni A, Tinneberg HR, Oberstein A, Rocha RM, Leonardi M, Condous G, Alsalem H, Keckstein J, Hudelist G. Accuracy of sonography for non-invasive detection of ovarian and deep endometriosis using #Enzian classification: prospective multicenter diagnostic accuracy study. Ultrasound Obstet Gynecol 2022; 59:385-391. [PMID: 34919760 DOI: 10.1002/uog.24833] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 10/12/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To compare the preoperative detection of endometriosis using transvaginal sonography (TVS) supplemented by transabdominal sonography (TAS) with surgical assessment of disease, using the #Enzian classification for endometriosis. METHODS This was a prospective multicenter diagnostic accuracy study of women undergoing TVS/TAS and radical surgery for deep endometriosis (DE) at different tertiary referral centers. The localization and grade of severity of the endometriotic lesions and adhesions were described according to the criteria of the #Enzian classification, both at preoperative ultrasound examination and during surgery. According to the #Enzian classification, the small pelvis is divided into three compartments for DE: A (rectovaginal septum and vagina); B (uterosacral and cardinal ligaments, parametrium and pelvic sidewalls); and C (rectum). In addition, further locations (F) are classified as adenomyosis (FA), urinary bladder involvement (FB) and ureteric involvement with signs of obstruction (FU). Other intestinal locations (FI) and other extragenital locations (FO) are also included. Ovarian endometriosis and adhesions at the level of the tubo-ovarian unit are listed as O and T, respectively. The #Enzian grade of severity (Grade 1-3) was determined for #Enzian compartments O, T, A, B and C based on the size of the lesion or the severity of the adhesions. Concordance between preoperative assessment using TVS/TAS and evaluation at surgery was assessed. The sensitivity, specificity, positive and negative predictive values and accuracy of TVS/TAS in the detection of endometriotic lesions/adhesions in the different #Enzian compartments were calculated. RESULTS In total, 745 women were included in the analysis. Preoperative TVS/TAS and surgical findings showed a concordance rate ranging between 86% and 99% for the presence or absence of endometriotic lesions/adhesions, depending on the evaluated #Enzian compartment. The concordance rate between TVS and surgery ranged between 71% and 92% for different severity grades, in #Enzian compartments O, T, A, B and C. Determining the presence or absence of adhesions at the level of the tubo-ovarian unit and classifying them accurately as Grade 1, 2 or 3 on TVS was more difficult than determining the presence and severity of endometriotic lesions in #Enzian compartments O, A, B and C. The sensitivity of TVS/TAS for the detection of endometriotic lesions ranged from 50% (#Enzian compartment FI) to 95% (#Enzian compartment A), specificity from 86% (#Enzian compartment Tleft ) to 99% (#Enzian compartment FI) and 100% (#Enzian compartments FB, FU and FO), positive predictive value from 90% (#Enzian compartment Tright ) to 100% (#Enzian compartment FO), negative predictive value from 74% (#Enzian compartment Bleft ) to 99% (#Enzian compartments FB and FU) and accuracy from 88% (#Enzian compartment Bright ) to 99% (#Enzian compartment FB). CONCLUSIONS The localization and severity of endometriotic lesions/adhesions, as described and classified according to the #Enzian classification, can be diagnosed accurately and non-invasively using TVS/TAS. The #Enzian classification provides a uniform classification system for describing endometriotic lesions, which can be used both at TVS/TAS and during surgical evaluation. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- E Montanari
- Department of Gynecology, Center for Endometriosis, Hospital St John of God, Vienna, Austria
| | - A Bokor
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - G Szabó
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - W Kondo
- Department of Gynecology and Minimally Invasive Unit, Vita Batel Hospital, Curitiba, Brazil
| | - C H Trippia
- Department of Radiology, Roentgen Diagnóstico Institute, Curitiba, Brazil
| | - M Malzoni
- Endoscopica Malzoni, Centre for Advanced Pelvic Surgery, Avellino, Italy
| | - A Di Giovanni
- Endoscopica Malzoni, Centre for Advanced Pelvic Surgery, Avellino, Italy
| | - H R Tinneberg
- Department of Obstetrics and Gynecology, Nordwest Hospital, Frankfurt, Germany
| | - A Oberstein
- Department of Obstetrics and Gynecology, Nordwest Hospital, Frankfurt, Germany
| | - R M Rocha
- Acute Gynaecology, Early Pregnancy and Advanced Endoscopy Surgery Unit, Nepean Hospital, Kingswood, NSW, Australia
- Sydney Medical School Nepean, University of Sydney, Sydney, NSW, Australia
| | - M Leonardi
- Sydney Medical School Nepean, University of Sydney, Sydney, NSW, Australia
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada
| | - G Condous
- Acute Gynaecology, Early Pregnancy and Advanced Endoscopy Surgery Unit, Nepean Hospital, Kingswood, NSW, Australia
- Sydney Medical School Nepean, University of Sydney, Sydney, NSW, Australia
| | - H Alsalem
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada
| | - J Keckstein
- Stiftung Endometrioseforschung (SEF), Westerstede, Germany
| | - G Hudelist
- Department of Gynecology, Center for Endometriosis, Hospital St John of God, Vienna, Austria
- Stiftung Endometrioseforschung (SEF), Westerstede, Germany
- Rudolfinerhaus Private Clinic, Vienna, Austria
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10
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Korkmaz-Icöz S, Liu B, Sayour A, Loganathan S, Radovits T, Karck M, Szabó G. The Sodium-Glucose Cotransporter-2 Inhibitor Canagliflozin Improves Graft Contractile Function following Heart Transplantation in Rats. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- S. Korkmaz-Icöz
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
| | - B. Liu
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
| | - A. Sayour
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
| | - S. Loganathan
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
| | | | - M. Karck
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
| | - G. Szabó
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
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11
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Korkmaz-Icöz S, Schwär M, Loganathan S, Wächter K, Sayour A, Kraft P, Mayer T, Radovits T, Simm A, Karck M, Szabó G. Nutritional Extracts Protect Rats’ Vascular Grafts from In Vitro Ischemia/Reperfusion Injury. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- S. Korkmaz-Icöz
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
| | - M. Schwär
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
| | - S. Loganathan
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
| | - K. Wächter
- Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland
| | - A. Sayour
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
| | - P. Kraft
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
| | - T. Mayer
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
| | | | - A. Simm
- Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland
| | - M. Karck
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
| | - G. Szabó
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
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12
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Korkmaz-Icöz S, Lian S, Ballikaya B, Loganathan S, Sayour A, Veres G, Radovits T, Karck M, Szabó G. Preservation of Arterial Grafts with Duragraft Alleviates Endothelial Dysfunction in a Rat Model of Bypass. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- S. Korkmaz-Icöz
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
| | - S. Lian
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
| | - B. Ballikaya
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
| | - S. Loganathan
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
| | - A. Sayour
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
| | - G. Veres
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
| | | | - M. Karck
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
| | - G. Szabó
- Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
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13
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Wächter K, Santos AN, Szabó G, Simm A. AGE-Rich Bread Crust Extract Boosts Oxidative Stress Interception via Stimulation of the NRF2 Pathway. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- K. Wächter
- Clinic for Cardiac Surgery, Halle (Saale), Deutschland
| | | | - G. Szabó
- Clinic for Cardiac Surgery, Halle (Saale), Deutschland
| | - A. Simm
- Clinic for Cardiac Surgery, Halle (Saale), Deutschland
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14
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Saemann L, Hoorn F, Georgevici AI, Korkmaz-Icöz S, Veres G, Karck M, Simm A, Wenzel F, Szabó G. The Use of a Cytokine Adsorber during Machine Perfusion of Donor Hearts Preserves the Coronary Microvascular Function. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- L. Saemann
- Department of Cardiac Surgery, University Hospital Halle, Halle (Saale), Deutschland
| | - F. Hoorn
- Department of Cardiac Surgery, University Hospital of Heidelberg, Heidelberg, Deutschland
| | - A. I. Georgevici
- Department of Cardiac Surgery, University Hospital Halle, Halle (Saale), Deutschland
| | - S. Korkmaz-Icöz
- Department of Cardiac Surgery, University Hospital of Heidelberg, Heidelberg, Deutschland
| | - G. Veres
- Department of Cardiac Surgery, University Hospital Halle, Halle (Saale), Deutschland
| | - M. Karck
- Department of Cardiac Surgery, University Hospital of Heidelberg, Heidelberg, Deutschland
| | - A. Simm
- Department of Cardiac Surgery, University Hospital Halle, Halle (Saale), Deutschland
| | - F. Wenzel
- Hochschule Furtwangen, Fakultät Medical and Life Sciences, Villingen-Schwenningen, Deutschland
| | - G. Szabó
- Department of Cardiac Surgery, University Hospital Halle, Halle (Saale), Deutschland
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15
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Winterhalter PR, Kosel M, Bartling B, Wächter K, Urazova A, Szabó G, Simm A. Effects of RAGE Overexpression on Heart Function in Mice Depend on Age and Sex. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725596] [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: 10/21/2022]
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16
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Ding Q, Loganathan S, Brlecic P, Sayour AA, Ruppert M, Radovits T, Korkmaz B, Karck M, Szabó G, Korkmaz-Icöz S. ALPHA-1-Antitrypsin Protects Vascular Grafts of Brain-Dead Rats against In Vitro Ischemia/Reperfusion Injury. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725680] [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: 10/21/2022]
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17
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Korkmaz-Icöz S, Abulizi S, Li K, Loganathan S, Korkmaz B, Brlecic P, Ruppert M, Sayour AA, Radovits T, Karck M, Szabó G. Preservation with Custodiol Solution Containing Alpha-1-Antitrypsin Improves Graft Function after Prolonged Cold Ischemic Storage in a Rat Model of Heart Transplantation. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725621] [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: 10/21/2022]
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18
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Korkmaz-Icöz S, Kocer C, Sayour AA, Benker MI, Abulizi S, Loganathan S, Brlecic P, Ruppert M, Radovits T, Karck M, Szabó G. The Sodium-Glucose Cotransporter-2 Inhibitor Canagliflozin Alleviates Endothelial Dysfunction of Vascular Grafts Submitted to In-Vitro Ischemia/Reperfusion Injury in Nondiabetic Rats. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725601] [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: 10/21/2022]
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19
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Loganathan S, Fiegen S, Guo Y, Ritscher E, Brlecic P, Sayour AA, Radovits T, Georgevici AI, Korkmaz B, Korkmaz-Icöz S, Karck M, Szabó G. ALPHA-1-Antitrypsin Preserves Cardiac Function and Reduces Damages Linked to Warm Ischemia/Reperfusion Injury in a Rodent Model of Cardiac Arrest and Resuscitation. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725600] [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: 10/21/2022]
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20
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Saemann L, Wenzel F, Kohl M, Korkmaz-Icöz S, Veres G, Simm A, Karck M, Szabó G. Development of a Prediction Model for Donor Heart Function Based on Myocardial Microcirculation during Ex Vivo Blood Perfusion. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725619] [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: 10/21/2022]
Affiliation(s)
| | | | - M. Kohl
- Villingen-Schwenningen, Deutschland
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21
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Korkmaz-Icöz S, Benker MI, Li S, Loganathan S, Brlecic P, Ruppert M, Sayour AA, Radovits T, Karck M, Szabó G. Vascular Reactivity in Old Spontaneously Hypertensive Stroke-Prone Rats: Effects of Prolonged Ischemia followed by Reperfusion. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725670] [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: 10/21/2022]
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22
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Aljassem M, Khizaneishvili L, Noutsias M, Hofmann B, Veres G, Szabó G. Impact of BMI on Postoperative Outcome after TAVI. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725830] [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: 10/21/2022]
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23
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Soso P, Brlecic P, Möbius A, Korkmaz-Icöz S, Brune M, Karck M, Szabó G. Comparison of Continuous Hypothermic Oxygenated Crystalloid Perfusion with the Novel Solution “Custodiol N ” and Warm Blood Perfusion in a Porcine DCD Donation Model. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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24
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Saemann L, Zubarevich A, Wenzel F, Korkmaz-Icöz S, Karck M, Szabó G, Veres G. Impact of Preparation Quality during Skeletonized Internal Mammary Artery Harvesting on Sternal Microcirculation. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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25
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Soethoff J, Korkmaz-Icöz S, Szabó G, Veres G. Comparison of Two Graft Storage Solutions (DuraGraft and TiProtec) in an In Vitro Model of Ischemia-Reperfusion Using Arterial Grafts. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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26
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Zhou P, Guo Y, Loganathan S, Radovits T, Brlecic P, Ruppert M, Sayour AA, Karck M, Korkmaz-Icöz S, Szabó G. Conditioned Medium from Mesenchymal Stem Cells Reduced Ischemia/Reperfusion Injury-Induced Endothelial Dysfunction in Rats’ Vascular Grafts. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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27
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Guo Y, Korkmaz-Icöz S, Jiang W, Brlecic P, Radovits T, Brune M, Yard B, Karck M, Loganathan S, Szabó G. N-Octanoyl Dopamine Is Superior to Dopamine in Protecting Graft Contractile Function when Administered to the Heart Transplant Recipients from Brain-Dead Donors. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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28
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Korkmaz-Icöz S, Akca D, Shiliang L, Loganathan S, Brlecic P, Ruppert M, Brune M, Radovits T, Karck M, Szabó G. Left-Ventricular Hypertrophy in 18-Month-Old Donor Hearts Was Not Associated with Graft Dysfunction in the Early Phase of Reperfusion after Cardiac Transplantation: Gene Expression Profiling. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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29
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Szabó G, Madár I, Bokor A, Bokor R, Csibi N, Rigó J. Usefulness of transvaginal strain elastography in the diagnosis of deep infiltrating endometriosis in the posterior compartment. Australas J Ultrasound Med 2019. [DOI: 10.1002/ajum.12145] [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)
- G. Szabó
- Obstetrics and Gynecology Department Semmelweis University Budapest Hungary
| | - I. Madár
- Obstetrics and Gynecology Department Semmelweis University Budapest Hungary
| | - A. Bokor
- Obstetrics and Gynecology Department Semmelweis University Budapest Hungary
| | - R. Bokor
- Obstetrics and Gynecology Department Semmelweis University Budapest Hungary
| | - N. Csibi
- Obstetrics and Gynecology Department Semmelweis University Budapest Hungary
| | - J. Rigó
- Obstetrics and Gynecology Department Semmelweis University Budapest Hungary
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30
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Madár I, Szabó G. Evaluation of IOTA simple rules and IOTA ADNEX model in the hands of expert examiners at the diagnosis of the adnexal tumors. Australas J Ultrasound Med 2019. [DOI: 10.1002/ajum.12151] [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: 11/08/2022] Open
Affiliation(s)
- I. Madár
- Obstetrics and Gynecology Department Semmelweis University Budapest Hungary
| | - G. Szabó
- Obstetrics and Gynecology Department Semmelweis University Budapest Hungary
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31
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Korkmaz-Icöz S, Zhou P, Guo Y, Loganathan S, Brlecic P, Radovits T, Ruppert M, Sayour A, Karck M, Szabó G. Conditioned Medium from Mesenchymal Stem Cells Protects Vascular Grafts of Brain-Dead Rats against In Vitro Ischemia/Reperfusion Injury. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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32
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Veres G, Hagenhoff M, Schmidt H, Radovits T, Loganathan S, Bai Y, Korkmaz-Icöz S, Brlecic P, Sayour A, Karck M, Szabó G. Targeting Phosphodiesterase-5 by Vardenafil Improves Vascular Graft Function. J Vasc Surg 2018. [DOI: 10.1016/j.jvs.2018.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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33
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Késmárszky R, Hannington T, Jakkel A, Szabó G. Rhinological observations during a humanitarian mission in a rural sub-Saharan African setting. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:S99-S102. [PMID: 30166227 DOI: 10.1016/j.anorl.2018.08.006] [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: 04/26/2018] [Revised: 06/22/2018] [Accepted: 08/07/2018] [Indexed: 10/28/2022]
Abstract
AIMS Patients with rhinological symptoms and pathologies represent an important population. Their prevalence in developing areas without ENT care is not well documented. Due to various factors like migration, they may have an influence out of these territories. Our objective was to determine the prevalence and epidemiology of the main rhinological symptoms and pathologies during a humanitarian mission. MATERIAL AND METHODS Six hundred and seventy nine patients presenting to our general medical consultations were examined. All of them had careful interrogation and a basic ENT check-up. Patient data and correlating photos were registered to be analyzed retrospectively. RESULTS The ethnic origins of the patients were different. Most of them were younger than 50 years old. The rhinological problems were amongst the most frequent reasons to consult, the prevalence was higher when secondary findings and complaints were also considered, representing altogether 44 (6.48%) cases. CONCLUSION A high prevalence of rhinological pathologies showing the importance of public health issues, screening and an important need of adapted treatments was found. Due to migration, climatic changes and humanitarian missions, their presentation and incidence may vary. Health care providers and rhinologists need a thorough knowledge of community acquired and tropical pathologies.
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Affiliation(s)
- R Késmárszky
- Deparment of ENT, Head and Neck Surgery, Hopital de la Misericorde, 27, avenue Imperatrice-Eugenie, 20000 Ajaccio, France.
| | - T Hannington
- Public Health Services, Buliisa district, Uganda
| | - A Jakkel
- Family physician, Kecskemét, Hungary
| | - G Szabó
- Family physician, Pócsmegyer, Hungary
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Sayour A, Ruppert M, Korkmaz-Icöz S, Li S, Brlecic P, Németh B, Oláh A, Horváth E, Merkely B, Karck M, Szabó G, Radovits T. Comparison of the anti-remodeling effect of pressure unloading and chronic soluble guanylate cyclase activation in rats with left ventricular myocardial hypertrophy. J Mol Cell Cardiol 2018. [DOI: 10.1016/j.yjmcc.2018.05.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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35
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Korkmaz-Icöz S, Li S, Loganathan S, Radovits T, Ruppert M, Brlecic P, Sayour A, Veres G, Fleming T, Brune M, Most P, Karck M, Szabó G. PI3K/Akt pathway alterations in transplanted diabetic hearts are involved in left-ventricular graft dysfunction. J Mol Cell Cardiol 2018. [DOI: 10.1016/j.yjmcc.2018.05.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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36
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Ruppert M, Korkmaz-Icöz S, Loganathan S, Jiang W, Lehmann L, Oláh A, Barta B, Merkely B, Karck M, Szabó G, Radovits T. The role of gender in the regression of pressure overload-induced left ventricular myocardial hypertrophy. J Mol Cell Cardiol 2018. [DOI: 10.1016/j.yjmcc.2018.05.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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37
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Korkmaz-Icöz S, Li K, Ruppert M, Loganathan S, Radovits T, Brlecic P, Karck M, Szabó G. Conservation of Hearts from Brain Dead Donors with a Preservation Solution Supplemented by a Conditioned Medium from Mesenchymal Stem Cells, Improves Graft Contractility After Heart Transplantation in Rats. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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38
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Korkmaz-Icöz S, Li K, Ruppert M, Loganathan S, Radovits T, Karck M, Szabó G. Cold Storage of Hearts from Brain-dead Donors using a Preservation Solution, Supplemented by a Mesenchymal Stem Cell Conditioned Medium Improves Contractile Function of Graft after Heart Transplantation in Rats. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- S. Korkmaz-Icöz
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - K. Li
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - M. Ruppert
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - S. Loganathan
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - T. Radovits
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - M. Karck
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - G. Szabó
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
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39
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Szabó G, Tochtermann U, De Simone R, Mkalaluh S, Karck M. The Novel Livanova 3D Rechord Semirigid Ring Facilitates Mitral Valve Repair with Artificial Chords: A Matched Pair Analysis. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- G. Szabó
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - U. Tochtermann
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - R. De Simone
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - S. Mkalaluh
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - M. Karck
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
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40
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Li S, Korkmaz-Icöz S, Radovits T, Ruppert M, Spindler R, Loganathan S, Hegedűs P, Brlecic P, Theisinger B, Theisinger S, Höger S, Brune M, Lasitschka F, Karck M, Yard B, Szabó G. Donor Preconditioning After the Onset of Brain Death With Dopamine Derivate n-Octanoyl Dopamine Improves Early Posttransplant Graft Function in the Rat. Am J Transplant 2017; 17:1802-1812. [PMID: 28117941 DOI: 10.1111/ajt.14207] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/23/2016] [Accepted: 01/10/2017] [Indexed: 01/25/2023]
Abstract
Heart transplantation is the therapy of choice for end-stage heart failure. However, hemodynamic instability, which has been demonstrated in brain-dead donors (BDD), could also affect the posttransplant graft function. We tested the hypothesis that treatment of the BDD with the dopamine derivate n-octanoyl-dopamine (NOD) improves donor cardiac and graft function after transplantation. Donor rats were given a continuous intravenous infusion of either NOD (0.882 mg/kg/h, BDD+NOD, n = 6) or a physiological saline vehicle (BDD, n = 9) for 5 h after the induction of brain death by inflation of a subdural balloon catheter. Controls were sham-operated (n = 9). In BDD, decreased left-ventricular contractility (ejection fraction; maximum rate of rise of left-ventricular pressure; preload recruitable stroke work), relaxation (maximum rate of fall of left-ventricular pressure; Tau), and increased end-diastolic stiffness were significantly improved after the NOD treatment. Following the transplantation, the NOD-treatment of BDD improved impaired systolic function and ventricular relaxation. Additionally, after transplantation increased interleukin-6, tumor necrosis factor TNF-α, NF-kappaB-p65, and nuclear factor (NF)-kappaB-p105 gene expression, and increased caspase-3, TNF-α and NF-kappaB protein expression could be significantly downregulated by the NOD treatment compared to BDD. BDD postconditioning with NOD through downregulation of the pro-apoptotic factor caspase-3, pro-inflammatory cytokines, and NF-kappaB may protect the heart against the myocardial injuries associated with brain death and ischemia/reperfusion.
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Affiliation(s)
- S Li
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany.,Department of Cardiovascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - S Korkmaz-Icöz
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - T Radovits
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - M Ruppert
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - R Spindler
- Department of Medicine V (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, Mannheim, Germany
| | - S Loganathan
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany.,Department of Anesthesiology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - P Hegedűs
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - P Brlecic
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | | | | | - S Höger
- Department of Medicine V (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, Mannheim, Germany.,Department of Clinical Pharmacology, University Medical Centre Mannheim, Mannheim, Germany
| | - M Brune
- Department of Medicine I and Clinical Chemistry, University Hospital Heidelberg, Heidelberg, Germany
| | - F Lasitschka
- Institute of Pathology, University Heidelberg, Heidelberg, Germany
| | - M Karck
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - B Yard
- Department of Medicine V (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, Mannheim, Germany
| | - G Szabó
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
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Li S, Korkmaz S, Ruppert M, Radovits T, Li K, Sun X, Brlecic P, Karck M, Szabó G. Continuous Hypothermic Perfusion of Old Donor Heart with a Preservation Solution Supplemented with Mesenchymal Stem Cell Conditioned Medium Improves Functional Graft Recovery During Prolonged Ischemic Time. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Lenz M, Galanis C, Müller-Dahlhaus F, Opitz A, Wierenga C, Szabó G, Ziemann U, Deller T, Funke K, Vlachos A. P292 10 Hz rTMS induces long-term depression of GABAergic neurotransmission. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2016.10.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Korkmaz-Icöz S, Brlecic P, Ruppert M, Radovits T, Li S, Sun X, Li K, Karck M, Szabó G. Mechanical Pressure Unloading Therapy Reverses Thoracic Aortic Structural and Functional Changes in a Rat Model of Abdominal Aortic Constriction-Induced Arterial Hypertension. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598939] [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: 10/20/2022]
Affiliation(s)
- S. Korkmaz-Icöz
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - P. Brlecic
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - M. Ruppert
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - T. Radovits
- Semmelweis University, Heart and Vascular Center, Budapest, Hungary
| | - S. Li
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - X. Sun
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - K. Li
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - M. Karck
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - G. Szabó
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
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Li S, Korkmaz-Icöz S, Ruppert M, Radovits T, Li K, Sun X, Brlecic P, Karck M, Szabó G. Old Donor Heart Preservation by Continuous Perfusion with a Preservation Solution Supplemented with Mesenchymal Stem Cell Conditioned Medium Protects Graft Function from Prolonged Cold Storage Followed by Warm Reperfusion. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598869] [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: 10/20/2022]
Affiliation(s)
- S. Li
- Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - S. Korkmaz-Icöz
- Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - M. Ruppert
- Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - T. Radovits
- Semmelweis University, Heart and Vascular Center, Budapest, Hungary
| | - K. Li
- Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - X. Sun
- Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - P. Brlecic
- Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - M. Karck
- Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - G. Szabó
- Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
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Szabó G. Relationship between tissue fluid and lymph in pathological conditions. Clin Hemorheol Microcirc 2016. [DOI: 10.3233/ch-1982-25-623] [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: 11/15/2022]
Affiliation(s)
- G. Szabó
- Traumatological Research unit., Budapest 1445., Hungary
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46
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Kivovics M, Szabó BT, Németh O, Tari N, Dőri F, Nagy P, Dobó-Nagy C, Szabó G. Microarchitectural study of the augmented bone following ridge preservation with a porcine xenograft and a collagen membrane: preliminary report of a prospective clinical, histological, and micro-computed tomography analysis. Int J Oral Maxillofac Surg 2016; 46:250-260. [PMID: 27839628 DOI: 10.1016/j.ijom.2016.10.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 07/23/2016] [Accepted: 10/20/2016] [Indexed: 10/20/2022]
Abstract
Socket preservation using a combination of porcine xenograft and collagen membrane maintains the vertical and horizontal dimensions of the ridge. The aim of this study was to evaluate the microarchitecture of the grafted area by histological analysis and micro-computed tomography. Patients in the test group (group 1; nine patients) underwent socket preservation, while the sockets in the control group (group 2; eight patients) were allowed to heal without preservation. After a 6-month healing period, bone core biopsy samples were obtained and implants were placed in the augmented sites in the test group (12 biopsy samples) and the non-augmented sockets of the control group (12 biopsy samples). Analysis of the biopsy samples obtained from group 1 revealed that particles of the graft were surrounded by newly formed bone in eight cases and by granulation tissue in four cases. Micromorphometric data showed statistically significant differences in several parameters between the microarchitecture of the native bone and the newly formed bone within the augmented sites, which suggests that the xenograft particles interfere with the bony healing of the alveoli.
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Affiliation(s)
- M Kivovics
- Department of Community Dentistry, Semmelweis University, Budapest, Hungary.
| | - B T Szabó
- Department of Oral Diagnostics, Semmelweis University, Budapest, Hungary
| | - O Németh
- Department of Community Dentistry, Semmelweis University, Budapest, Hungary
| | - N Tari
- Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - F Dőri
- Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - P Nagy
- Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - C Dobó-Nagy
- Department of Oral Diagnostics, Semmelweis University, Budapest, Hungary
| | - G Szabó
- Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Budapest, Hungary
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Ajtai T, Pintér M, Utry N, Kiss-Albert G, Gulyás G, Pusztai P, Puskás R, Bereczky Á, Szabados G, Szabó G, Kónya Z, Bozóki Z. Characterisation of diesel particulate emission from engines using commercial diesel and biofuels. Atmospheric Environment 2016. [DOI: 10.1016/j.atmosenv.2016.03.046] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Hirschberg K, Wiedmann F, Zitron E, Fortner P, Riffel JH, Chorianopoulos E, Gdynia G, Mechtersheimer G, Andrassy M, Szabó G, Arif R, Katus HA, Buss SJ. Incidental finding of a giant intracardiac angioma infiltrating both ventricles in a 35-year-old woman: a case report. J Med Case Rep 2016; 10:94. [PMID: 27071931 PMCID: PMC4830042 DOI: 10.1186/s13256-016-0860-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 03/02/2016] [Indexed: 11/23/2022] Open
Abstract
Background Primary cardiac tumors are rare and often asymptomatic or present with unspecific symptoms. Benign cardiac tumors of vascular origin are especially rare, with only few existing data in the literature. Case presentation A 35-year-old Caucasian female patient presented to our department with an asymptomatic giant intracardiac angioma infiltrating both ventricles. Evaluation of this tumor involved electrocardiography, echocardiography, cardiac magnetic resonance imaging, coronary angiography, an open myocardial biopsy, and histological examination of the resected specimen. Because our patient was asymptomatic, she was managed conservatively with regular follow-up. We discuss the treatment options available in comparison with similar cases. Conclusion Diagnosis and therapy of benign cardiac tumors, especially of asymptomatic lesions, can be a challenge. There is no evidence available to help in the management of such patients. An extensive evaluation is needed with different imaging modalities, and case-specific decisions should be made that involve experts in cardiology, cardio-oncology, and heart surgery. Electronic supplementary material The online version of this article (doi:10.1186/s13256-016-0860-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- K Hirschberg
- Department of Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
| | - F Wiedmann
- Department of Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - E Zitron
- Department of Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - P Fortner
- Department of Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - J H Riffel
- Department of Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - E Chorianopoulos
- Department of Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - G Gdynia
- Institute of Pathology, University of Heidelberg, Im Neuenheimer Feld 220/221, 69120, Heidelberg, Germany
| | - G Mechtersheimer
- Institute of Pathology, University of Heidelberg, Im Neuenheimer Feld 220/221, 69120, Heidelberg, Germany
| | - M Andrassy
- Fürst-Stirum-Klinik, Gutleutstraße 1-14, 76646, Bruchsal, Germany
| | - G Szabó
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - R Arif
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - H A Katus
- Department of Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - S J Buss
- Department of Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
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Li S, Korkmaz-Icöz S, Radovits T, Hegedűs P, Karck M, Szabó G. Evaluation of Graft Function in Which Donor Hearts Were Retrieved under Exsanguination- or Apnea-Induced Non–Heart-Beating Conditions. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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50
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Szabó G, Gose C, Rengier F, Hilbel T, Kauczor HU, Karck M. Computer Assisted Ventricular Surgery (CAVE): a Novel Tool to Improve Outcome of Ventricular Restoration Surgery. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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