1
|
Branco AC, Silva R, Jorge H, Santos T, Lorenz K, Polido M, Colaço R, Serro AP, Figueiredo-Pina CG. Corrigendum to "Tribological performance of the pair human teeth vs 3D printed zirconia: An in vitro chewing simulation study" [J. Mech. Behav. Biomed. Mater. 110 (2020) 103900]. J Mech Behav Biomed Mater 2023; 147:106041. [PMID: 37544794 DOI: 10.1016/j.jmbbm.2023.106041] [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: 08/08/2023]
Affiliation(s)
- A C Branco
- CQE, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal; CDP2T, Escola Superior de Tecnologia de Setúbal, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - R Silva
- CQE, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - H Jorge
- Centro Tecnológico da Cerâmica e Do Vidro (CTCV), Coimbra, Portugal
| | | | - K Lorenz
- INESC-MN, IPFN, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - M Polido
- CiiEM, Escola Superior de Saúde Egas Moniz, Monte de Caparica, Portugal
| | - R Colaço
- IDMEC e Departamento de Engenharia Mecânica, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - A P Serro
- CQE, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal; CiiEM, Escola Superior de Saúde Egas Moniz, Monte de Caparica, Portugal.
| | - C G Figueiredo-Pina
- CDP2T, Escola Superior de Tecnologia de Setúbal, Instituto Politécnico de Setúbal, Setúbal, Portugal; CiiEM, Escola Superior de Saúde Egas Moniz, Monte de Caparica, Portugal; CeFEMA, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| |
Collapse
|
2
|
Branco AC, Silva R, Santos T, Jorge H, Rodrigues AR, Fernandes R, Bandarra S, Barahona I, Matos APA, Lorenz K, Polido M, Colaço R, Serro AP, Figueiredo-Pina CG. Corrigendum to "Suitability of 3D printed nanostructured zirconia pieces for dental applications" [Dent Mater 36 (2020) 442-455]. Dent Mater 2023; 39:861. [PMID: 37544861 DOI: 10.1016/j.dental.2023.08.002] [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: 08/08/2023]
Affiliation(s)
- A C Branco
- CQE, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal; CDP2T, Escola Superior de Tecnologia de Setúbal, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - R Silva
- CQE, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | | | - H Jorge
- Centro Tecnológico da Cerâmica e do Vidro (CTCV), Coimbra, Portugal
| | - A R Rodrigues
- CDP2T, Escola Superior de Tecnologia de Setúbal, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - R Fernandes
- CDP2T, Escola Superior de Tecnologia de Setúbal, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - S Bandarra
- CiiEM, Instituto Universitário Egas Moniz, Monte de Caparica, Portugal
| | - I Barahona
- CiiEM, Instituto Universitário Egas Moniz, Monte de Caparica, Portugal
| | - A P A Matos
- CiiEM, Instituto Universitário Egas Moniz, Monte de Caparica, Portugal
| | - K Lorenz
- INESC-MN, IPFN, Instituto Superior Técnico, Universidade de Lisboa, Bobadela, Portugal
| | - M Polido
- CiiEM, Instituto Universitário Egas Moniz, Monte de Caparica, Portugal
| | - R Colaço
- IDMEC e Departamento de Engenharia Mecânica, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - A P Serro
- CQE, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal; CiiEM, Instituto Universitário Egas Moniz, Monte de Caparica, Portugal.
| | - C G Figueiredo-Pina
- CDP2T, Escola Superior de Tecnologia de Setúbal, Instituto Politécnico de Setúbal, Setúbal, Portugal; CiiEM, Instituto Universitário Egas Moniz, Monte de Caparica, Portugal; CeFEMA, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| |
Collapse
|
3
|
Esteves DM, Rodrigues AL, Alves LC, Alves E, Dias MI, Jia Z, Mu W, Lorenz K, Peres M. Probing the Cr 3+ luminescence sensitization in β-Ga 2O 3 with ion-beam-induced luminescence and thermoluminescence. Sci Rep 2023; 13:4882. [PMID: 36966173 PMCID: PMC10039926 DOI: 10.1038/s41598-023-31824-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/17/2023] [Indexed: 03/27/2023] Open
Abstract
Ion-beam-induced luminescence (IBIL) measurements were performed in Cr-doped β-Ga2O3 using both protons and helium ions, showing a strong enhancement of the Cr3+ luminescence upon ion irradiation. Theoretical modelling of the IBIL intensity curves as a function of the fluence allowed estimating the effective cross-sections associated with the defect-induced IBIL enhancement and quenching processes. The results suggest that sensitizing the Cr3+ luminescence is more efficient for H+ than for He+ irradiation. Thermoluminescence (TL) studies were performed in the pristine sample, with no TL signal being observed in the spectral region corresponding to the Cr3+ emission. In agreement with the IBIL study, upon ion irradiation (with either protons or helium ions), this TL emission is activated. Moreover, it can be quenched by annealing at 923 K for 10 s, thus revealing the role played by the defects induced by the irradiation. These results show that the irradiation-induced defects play a major role in the activation of the Cr3+ luminescence, a fact that can be exploited for radiation sensing and dosimetry.
Collapse
Affiliation(s)
- D M Esteves
- INESC MN, Rua Alves Redol 9, 1000-029, Lisbon, Portugal.
- IPFN, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais 1, 1049-001, Lisbon, Portugal.
| | - A L Rodrigues
- C2TN, Instituto Superior Técnico, University of Lisbon, Estrada Nacional 10, km 139.7, 2695-066, Bobadela, Portugal
| | - L C Alves
- C2TN, Instituto Superior Técnico, University of Lisbon, Estrada Nacional 10, km 139.7, 2695-066, Bobadela, Portugal
- DECN, Instituto Superior Técnico, University of Lisbon, Estrada Nacional 10, km 139.7, 2695-066, Bobadela, Portugal
| | - E Alves
- IPFN, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais 1, 1049-001, Lisbon, Portugal
- DECN, Instituto Superior Técnico, University of Lisbon, Estrada Nacional 10, km 139.7, 2695-066, Bobadela, Portugal
| | - M I Dias
- C2TN, Instituto Superior Técnico, University of Lisbon, Estrada Nacional 10, km 139.7, 2695-066, Bobadela, Portugal
- DECN, Instituto Superior Técnico, University of Lisbon, Estrada Nacional 10, km 139.7, 2695-066, Bobadela, Portugal
| | - Z Jia
- State Key Laboratory of Crystal Materials, Shandong University, Shandanan Street 27, Jinan, 250100, China
| | - W Mu
- State Key Laboratory of Crystal Materials, Shandong University, Shandanan Street 27, Jinan, 250100, China
| | - K Lorenz
- INESC MN, Rua Alves Redol 9, 1000-029, Lisbon, Portugal
- IPFN, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais 1, 1049-001, Lisbon, Portugal
- DECN, Instituto Superior Técnico, University of Lisbon, Estrada Nacional 10, km 139.7, 2695-066, Bobadela, Portugal
| | - M Peres
- INESC MN, Rua Alves Redol 9, 1000-029, Lisbon, Portugal
- IPFN, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais 1, 1049-001, Lisbon, Portugal
- DECN, Instituto Superior Técnico, University of Lisbon, Estrada Nacional 10, km 139.7, 2695-066, Bobadela, Portugal
| |
Collapse
|
4
|
Clement SC, Visser WE, Lebbink CA, Albano D, Claahsen-van der Grinten HL, Czarniecka A, Dias RP, Dierselhuis MP, Dzivite-Krisane I, Elisei R, Garcia-Burillo A, Izatt L, Kanaka-Gantenbein C, Krude H, Lamartina L, Lorenz K, Luster M, Navardauskaitė R, Negre Busó M, Newbold K, Peeters RP, Pellegriti G, Piccardo A, Priego AL, Redlich A, de Sanctis L, Sobrinho-Simões M, van Trotsenburg ASP, Verburg FA, Vriens M, Links TP, Ahmed SF, van Santen HM. Development of a pediatric differentiated thyroid carcinoma registry within the EuRRECa project: rationale and protocol. Endocr Connect 2023; 12:e220306. [PMID: 37931414 PMCID: PMC9986407 DOI: 10.1530/ec-22-0306] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 01/10/2023] [Indexed: 10/06/2023]
Abstract
Background Although differentiated thyroid carcinoma (DTC) is the most frequent endocrine pediatric cancer, it is rare in childhood and adolescence. While tumor persistence and recurrence are not uncommon, mortality remains extremely low. Complications of treatment are however reported in up to 48% of the survivors. Due to the rarity of the disease, current treatment guidelines are predominantly based on the results of small observational retrospective studies and extrapolations from results in adult patients. In order to develop more personalized treatment and follow-up strategies (aiming to reduce complication rates), there is an unmet need for uniform international prospective data collection and clinical trials. Methods and analysis The European pediatric thyroid carcinoma registry aims to collect clinical data for all patients ≤18 years of age with a confirmed diagnosis of DTC who have been diagnosed, assessed, or treated at a participating site. This registry will be a component of the wider European Registries for Rare Endocrine Conditions project which has close links to Endo-ERN, the European Reference Network for Rare Endocrine Conditions. A multidisciplinary expert working group was formed to develop a minimal dataset comprising information regarding demographic data, diagnosis, treatment, and outcome. We constructed an umbrella-type registry, with a detailed basic dataset. In the future, this may provide the opportunity for research teams to integrate clinical research questions. Ethics and dissemination Written informed consent will be obtained from all participants and/or their parents/guardians. Summaries and descriptive analyses of the registry will be disseminated via conference presentations and peer-reviewed publications.
Collapse
Affiliation(s)
- S C Clement
- Department of Pediatrics, Emma Children’s Hospital, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Department of Pediatric Endocrinology, Wilhelmina Children’s Hospital/ University Medical Center Utrecht, Utrecht, The Netherlands
| | - W E Visser
- Academic Center For Thyroid Disease, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - C A Lebbink
- Department of Pediatric Endocrinology, Wilhelmina Children’s Hospital/ University Medical Center Utrecht, Utrecht, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - D Albano
- Department of Nuclear Medicine, University of Brescia and Spedali Civili of Brescia, Brescia, Italy
| | - H L Claahsen-van der Grinten
- Department of Pediatrics, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, The Netherlands
| | - A Czarniecka
- The Oncologic and Reconstructive Surgery Clinic, M. Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - R P Dias
- Department of Endocrinology and Diabetes, Birmingham Children’s Hospital, Birmingham Women’s, and Children’s NHS Foundation Trust, Birmingham, UK
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - M P Dierselhuis
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - I Dzivite-Krisane
- Department of Pediatric Endocrinology, Children's Clinical University Hospital, Riga, Latvia
| | - R Elisei
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - A Garcia-Burillo
- Nuclear Medicine Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - L Izatt
- Department of Clinical Genetics, Guy's and St Thomas’ NHS Foundation Trust, London, UK
| | - C Kanaka-Gantenbein
- Division of Endocrinology, Diabetes, and Metabolism, First Department of Pediatrics National and Kapodistrian University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, Greece
| | - H Krude
- Institute of Experimental Pediatric Endocrinology, Charité - Universitätsmedizin, Berlin, Germany
| | - L Lamartina
- Department of Endocrine Oncology, Gustave Roussy, Villejuif, France
| | - K Lorenz
- Department of Visceral, Vascular and Endocrine Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - M Luster
- Department of Nuclear Medicine, University Hospital Marburg, Marburg, Germany
| | - R Navardauskaitė
- Department of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - M Negre Busó
- Nuclear Medicine Service - Institut de diagnòstic per la Imatge, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain
| | - K Newbold
- Thyroid Therapy Unit, The Royal Marsden NHS Foundation Trust Hospital, London, UK
| | - R P Peeters
- Academic Center For Thyroid Disease, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - G Pellegriti
- Endocrinology, Endocrinology Division, Garibaldi-Nesima Medical Center, Catania, Italy
| | - A Piccardo
- Department of Nuclear Medicine, EO Ospedali Galliera, Genoa, Italy
| | - A L Priego
- Department of Medicine, Division of Endocrinology, Leiden, University medical Center, Leiden, The Netherlands
| | - A Redlich
- Pediatric Oncology Department, Otto von Guericke University Children's Hospital, Magdeburg, Germany
| | - L de Sanctis
- Regina Margherita Children Hospital - Department of Public Health and Pediatric Sciences, University of Torino, Torino, Italy
| | - M Sobrinho-Simões
- University Hospital of São João, Medical Faculty and Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal
| | - A S P van Trotsenburg
- Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - F A Verburg
- Department of Radiology & Nuclear Medicine, Erasmus MC Rotterdam, Rotterdam, The Netherlands
| | - M Vriens
- Department of Endocrine Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - T P Links
- Department of Endocrinology, University Medical Center Groningen, Groningen, The Netherlands
| | - S F Ahmed
- Endocrinology, Endocrinology Division, Garibaldi-Nesima Medical Center, Catania, Italy
- Developmental Endocrinology Research Group, Royal Hospital for Children, University of Glasgow, Glasgow, UK
- Office for Rare Conditions, University of Glasgow, Glasgow, UK
| | - H M van Santen
- Department of Pediatric Endocrinology, Wilhelmina Children’s Hospital/ University Medical Center Utrecht, Utrecht, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| |
Collapse
|
5
|
Dierks C, Ruf J, Seufert J, Kreissl M, Klein C, Spitzweg C, Kroiss M, Thomusch O, Lorenz K, Zielke A, Miething C. 1646MO Phase II ATLEP trial: Final results for lenvatinib/pembrolizumab in metastasized anaplastic and poorly differentiated thyroid carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1726] [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: 11/01/2022] Open
|
6
|
Haxel B, Hummel T, Fruth K, Lorenz K, Gunder N, Nahrath P, Cuevas M. Real-world-effectiveness of biological treatment for severe chronic rhinosinusitis with nasal polyps. Rhinology 2022; 60:435-443. [DOI: 10.4193/rhin22.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Background: During the last two years, three different monoclonal antibodies have been approved in many countries for the treatment of patients suffering from severe chronic rhinosinusitis with nasal polyps (CRSwNP). Their efficacy has been demonstrated through large double-blind placebo-controlled clinical studies. Until now, only very limited reports on real-world data regarding this therapy have been published. Methods: This per protocol analysis included patients with an indication for biological treatment because of uncontrolled CRSwNP, despite long-term nasal steroid treatment, systemic steroid use and/ or endonasal sinus surgery. Baseline data on demographics, medical history and comorbidities, polyp score, quality of life and sense of smell (using Sniffin´ Sticks) were assessed and a treatment with either dupilumab or omalizumab was started. The patients were followed up after three and six months. The changes in polyp score, quality-of-life measures and olfaction were noted. Results: 70 consecutive patients were evaluated during the study. Of the patients, 49 were treated with dupilumab and 21 with omalizumab. The polyp score decreased significantly after three and six months, and the quality-of-life parameters and olfaction increased. More than 90% of patients showed a moderate to excellent response to the therapy and there was no difference in the overall response between the two treatments. Olfaction improved in two thirds of the patients, but one third was still anosmic after six months treatment. Conclusions: This real-world study shows the effectiveness of the monoclonal antibodies dupilumab and omalizumab in the treatment of severe CRSwNP. Nasal polyp scores and quality-of-life parameters as well as measured olfactory function were improved after just three months. The response after guideline-based criteria was insufficient only in 5 patients of this cohort.
Collapse
|
7
|
Tolstik E, Gongalsky MB, Dierks J, Brand T, Pernecker M, Pervushin NV, Maksutova DE, Gonchar KA, Samsonova JV, Kopeina G, Sivakov V, Osminkina LA, Lorenz K. Raman and fluorescence micro-spectroscopy applied for the monitoring of sunitinib-loaded porous silicon nanocontainers in cardiac cells. Front Pharmacol 2022; 13:962763. [PMID: 36016563 PMCID: PMC9397571 DOI: 10.3389/fphar.2022.962763] [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: 06/06/2022] [Accepted: 07/05/2022] [Indexed: 11/17/2022] Open
Abstract
Nanomaterials are a central pillar in modern medicine. They are thought to optimize drug delivery, enhance therapeutic efficacy, and reduce side-effects. To foster this technology, analytical methods are needed to validate not only the localization and distribution of these nanomaterials, but also their compatibility with cells, drugs, and drug release. In the present work, we assessed nanoparticles based on porous silicon (pSiNPs) loaded with the clinically used tyrosine kinase inhibitor sunitinib for their effectiveness of drug delivery, release, and toxicity in colon cancer cells (HCT 116 cells) and cardiac myoblast cells (H9c2) using Raman micro-spectroscopy, high-resolution fluorescence microscopy, along with biological methods for toxicological effects. We produced pSiNPs with a size of about 100 nm by grinding mesoporous silicon layers. pSiNPs allowed an effective loading of sunitinib due to their high porosity. Photoluminescence properties of the nanoparticles within the visible spectrum allowed the visualization of their uptake in cardiac cells. Raman micro-spectroscopy allowed not only the detection of the uptake and distribution of pSiNPs within the cells via a characteristic silicon Raman band at about 518–520 cm−1, but also the localization of the drug based on its characteristic molecular fingerprints. Cytotoxicity studies by Western blot analyses of apoptotic marker proteins such as caspase-3, and the detection of apoptosis by subG1-positive cell fractions in HCT 116 and MTT analyses in H9c2 cells, suggest a sustained release of sunitinib from pSiNPs and delayed cytotoxicity of sunitinib in HCT 116 cells. The analyses in cardiac cells revealed that pSiNPs are well tolerated and that they may even protect from toxic effects in these cells to some extent. Analyses of the integrity of mitochondrial networks as an early indicator for apoptotic cellular effects seem to validate these observations. Our study suggests pSiNPs-based nanocontainers for efficient and safe drug delivery and Raman micro-spectroscopy as a reliable method for their detection and monitoring. Thus, the herein presented nanocontainers and analytical methods have the potential to allow an efficient advancement of nanoparticles for targeted and sustained intracellular drug release that is of need, e.g., in chronic diseases and for the prevention of cardiac toxicity.
Collapse
Affiliation(s)
- E. Tolstik
- Leibniz-Institut für Analytische Wissenschaften—ISAS—e.V., Dortmund, Germany
- *Correspondence: E. Tolstik, elen.tolstik@isas; L. A. Osminkina, ; K. Lorenz,
| | - M. B. Gongalsky
- Lomonosov Moscow State University, Faculty of Physics, Moscow, Russia
| | - J. Dierks
- Leibniz-Institut für Analytische Wissenschaften—ISAS—e.V., Dortmund, Germany
| | - T. Brand
- Institute of Pharmacology and Toxicology, University of Würzburg, Würzburg, Germany
| | - M. Pernecker
- Leibniz-Institut für Analytische Wissenschaften—ISAS—e.V., Dortmund, Germany
| | - N. V. Pervushin
- Lomonosov Moscow State University, Faculty of Medicine, Moscow, Russia
| | - D. E. Maksutova
- Lomonosov Moscow State University, Faculty of Physics, Moscow, Russia
| | - K. A. Gonchar
- Lomonosov Moscow State University, Faculty of Physics, Moscow, Russia
| | - J. V. Samsonova
- Lomonosov Moscow State University, Faculty of Chemistry, Moscow, Russia
| | - G. Kopeina
- Lomonosov Moscow State University, Faculty of Medicine, Moscow, Russia
| | - V. Sivakov
- Leibniz Institute of Photonic Technology, Department Functional Interfaces, Jena, Germany
| | - L. A. Osminkina
- Lomonosov Moscow State University, Faculty of Physics, Moscow, Russia
- Institute for Biological Instrumentation of Russian Academy of Sciences, Moscow, Russia
- *Correspondence: E. Tolstik, elen.tolstik@isas; L. A. Osminkina, ; K. Lorenz,
| | - K. Lorenz
- Leibniz-Institut für Analytische Wissenschaften—ISAS—e.V., Dortmund, Germany
- Institute of Pharmacology and Toxicology, University of Würzburg, Würzburg, Germany
- Comprehensive Heart Failure Center, University Hospital of Würzburg, Würzburg, Germany
- *Correspondence: E. Tolstik, elen.tolstik@isas; L. A. Osminkina, ; K. Lorenz,
| |
Collapse
|
8
|
Vázquez L, Redondo-Cubero A, Lorenz K, Palomares FJ, Cuerno R. Surface nanopatterning by ion beam irradiation: compositional effects. J Phys Condens Matter 2022; 34:333002. [PMID: 35654034 DOI: 10.1088/1361-648x/ac75a1] [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] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
Surface nanopatterning induced by ion beam irradiation (IBI) has emerged as an effective nanostructuring technique since it induces patterns on large areas of a wide variety of materials, in short time, and at low cost. Nowadays, two main subfields can be distinguished within IBI nanopatterning depending on the irrelevant or relevant role played by the surface composition. In this review, we give an up-dated account of the progress reached when surface composition plays a relevant role, with a main focus on IBI surface patterning with simultaneous co-deposition of foreign atoms. In addition, we also review the advances in IBI of compound surfaces as well as IBI systems where the ion employed is not a noble gas species. In particular, for the IBI with concurrent metal co-deposition, we detail the chronological evolution of these studies because it helps us to clarify some contradictory early reports. We describe the main patterns obtained with this technique as a function of the foreign atom deposition pathway, also focusing in those systematic studies that have contributed to identify the main mechanisms leading to the surface pattern formation and development. Likewise, we explain the main theoretical models aimed at describing these nanopattern formation processes. Finally, we address two main special features of the patterns induced by this technique, namely, the enhanced pattern ordering and the possibility to produce both morphological and chemical patterns.
Collapse
Affiliation(s)
- L Vázquez
- Instituto de Ciencia de Materiales de Madrid (ICMM), CSIC, C/Sor Juana Inés de la Cruz 3, 28049 Madrid, Spain
| | - A Redondo-Cubero
- Grupo de Electrónica y Semiconductores, Departamento de Física Aplicada, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Centro de Micro-Análisis de Materiales, Universidad Autónoma de Madrid, C/Faraday 2, 28049 Madrid, Spain
| | - K Lorenz
- Instituto Superior Técnico, Universidade de Lisboa, Campus Tecnológico e Nuclear, Estrada Nacional 10, km 139.7, 2695-066 Bobadela LRS, Portugal
- Instituto de Engenharia de Sistemas e Computadores-Microsistemas e Nanotecnologia (INESC-MN), Rua Alves Redol 9, 1000-029 Lisboa, Portugal
| | - F J Palomares
- Instituto de Ciencia de Materiales de Madrid (ICMM), CSIC, C/Sor Juana Inés de la Cruz 3, 28049 Madrid, Spain
| | - R Cuerno
- Departamento de Matemáticas and Grupo Interdisciplinar de Sistemas Complejos (GISC), Universidad Carlos III de Madrid, E-28911 Leganés, Spain
| |
Collapse
|
9
|
Holz FG, Schmitz-Valckenberg S, Wolf A, Agostini H, Lorenz K, Pielen A, Feltgen N, Guthoff R, Quiering C, Clemens A, Jaeger K. A randomized, open-label, multicenter study of switching to brolucizumab with or without a loading dose for patients with suboptimal anatomically controlled neovascular age-related macular degeneration-the FALCON study. Graefes Arch Clin Exp Ophthalmol 2022; 260:2695-2702. [PMID: 35188581 PMCID: PMC9325853 DOI: 10.1007/s00417-022-05591-z] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 01/24/2022] [Accepted: 02/10/2022] [Indexed: 01/06/2023] Open
Abstract
Background Treatment initiation with brolucizumab, a new potent anti-vascular endothelial growth factor (VEGF) agent, is typically performed with three monthly injections (loading dose) and has been well studied in treatment-naïve patients. However, no clinical data are available yet on whether or not anti-VEGF pretreated patients also benefit from a loading dose. In the clinical setting, different heterogeneous treatment patterns are used as no clinical trial has addressed this so far in a head-to-head comparison. Therefore, the FALCON study is investigating whether patients with unsatisfactory response to previous anti-VEGF treatments benefit from a loading dose at the switch to brolucizumab treatment. Methods FALCON is a 52-week, two-arm, randomized, open-label, multicenter, multinational study in patients with residually active neovascular age-related macular degeneration (nAMD) who will be randomized 1:1 and started with brolucizumab 6 mg loading (three monthly loading doses) or brolucizumab 6 mg non-loading (one initial injection) and consecutive treatment every 12 weeks, respectively. The primary objective is to demonstrate non-inferiority of the non-loading vs. loading arm in mean change of best-corrected visual acuity (BCVA) from baseline to the mean value at week 40 to week 52. Secondary objectives include the assessment of anatomical outcomes, treatment intervals, safety and tolerability. Results FALCON will be the first study to assess treatment initiation with an anti-VEGF agent in a switch situation with or without loading dose in patients with nAMD. Conclusions The results will support the optimization of treatment of patients with previous unsatisfactory anti-VEGF response. Therefore, we expect to see an impact on current clinical practice which has been established for more than a decade. Trial registration Clinicaltrials.gov: NCT04679935, date of registration—22-Dec 2020; EUDRACT number: 2019–004763-53, date of registration—03 Dec 2019.
Collapse
Affiliation(s)
- F G Holz
- Department of Ophthalmology and GRADE Reading Center, University of Bonn, Bonn, Germany
| | - Steffen Schmitz-Valckenberg
- Department of Ophthalmology and GRADE Reading Center, University of Bonn, Bonn, Germany. .,Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, 65 North Mario Capecchi Drive, Salt Lake City, UT, 84312, USA.
| | - A Wolf
- Department of Ophthalmology, University of Ulm, Ulm, Germany
| | - H Agostini
- Eye Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - K Lorenz
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - A Pielen
- University Eye Hospital, Medizinische Hochschule Hannover, Hannover, Germany
| | - N Feltgen
- Eye Center, Faculty of Medicine, University of Goettingen, Goettingen, Germany
| | - R Guthoff
- Eye Hospital, Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany
| | - C Quiering
- Novartis Pharma GmbH, Nuernberg, Germany
| | - A Clemens
- Novartis Pharma AG, Basel, Switzerland.,Department of Cardiology and Angiology I, Faculty of Medicine, Heart Center, University of Freiburg, Freiburg, Germany
| | - K Jaeger
- Novartis Pharma GmbH, Nuernberg, Germany
| |
Collapse
|
10
|
Weber T, Dotzenrath C, Trupka A, Schabram P, Lorenz K, Dralle H. [Medicolegal aspects of primary and renal hyperparathyroidism]. Chirurg 2021; 93:596-603. [PMID: 34874460 DOI: 10.1007/s00104-021-01535-1] [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] [Accepted: 10/25/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Compared with malpractice claims in thyroid surgery, expert medico-legal reviews of surgery performed for hyperparathyroidism (HPT) that aim to prove or rebut surgical malpractice are rare. The aim of this analysis was to describe typical risk patterns for possible treatment errors and to generate recommendations for avoiding these treatment errors. MATERIAL AND METHODS A total of 12 surgical expert medico-legal reviews, which were carried out by order of 9 arbitration boards and 3 courts between 1997 and 2020 were evaluated. RESULTS If the indications for surgical treatment of hyperparathyroidism were present, the failure to identify a parathyroid adenoma or hyperplastic parathyroid glands was in the majority of cases not rated as a surgical treatment error, especially in atypical localizations. Unilateral recurrent laryngeal nerve palsy and postoperative bleeding cannot always be prevented, despite maximum diligence. In contrast, bilateral recurrent laryngeal nerve palsy can be prevented when intraoperative neuromonitoring is correctly applied. A lack of patient information regarding postoperatively persistent HPT, postoperative hypoparathyroidism following the removal of inconspicuous parathyroid glands and nonindicated lobectomy or total thyroidectomy, mostly performed under the assumption of an intrathyroid parathyroid adenoma, represented avoidable malpractice issues. CONCLUSION Advanced knowledge of the pathophysiology of the disease and the anatomy of the parathyroid glands as well as the establishment of intraoperative and perioperative standards can prospectively greatly reduce avoidable errors in the surgical treatment and postoperative care of HPT.
Collapse
Affiliation(s)
- T Weber
- Klinik für Endokrine Chirurgie, Marienhaus Klinikum Mainz, An der Goldgrube 11, 55131, Mainz, Deutschland.
| | - C Dotzenrath
- Helios Universitätsklinikum Wuppertal, Wuppertal, Deutschland
| | - A Trupka
- Klinikum Starnberg, Starnberg, Deutschland
| | - P Schabram
- Kanzlei Ratajczak & Partner, Freiburg, Deutschland
| | - K Lorenz
- Universitätsklinikum Halle, Halle, Deutschland
| | - H Dralle
- Universitätsklinikum Essen, Essen, Deutschland
| |
Collapse
|
11
|
Schneider R, Machens A, Sekulla C, Lorenz K, Elwerr M, Dralle H. Superiority of continuous over intermittent intraoperative nerve monitoring in preventing vocal cord palsy. Br J Surg 2021; 108:566-573. [PMID: 34043775 DOI: 10.1002/bjs.11901] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 04/20/2020] [Accepted: 06/14/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Continuous intraoperative nerve stimulation (IONM) with uninterrupted monitoring is likely better than intermittent IONM in preventing vocal cord palsy after thyroid surgery. METHODS This was a comparative study of intermittent versus continuous IONM in patients with benign and malignant thyroid disease treated at a tertiary centre over 10 years. Early postoperative and permanent vocal cord palsy rates were estimated. Multivariable logistic regression analysis was used to quantify the contributions of clinical and histopathological variables to early postoperative and permanent vocal cord palsy. RESULTS A total of 6029 patients were included, of whom 3139 underwent continuous and 2890 intermittent IONM. Based on nerves at risk (5208 versus 5024 nerves), continuous IONM had a 1·7-fold lower early postoperative vocal cord palsy rate than intermittent monitoring (1·5 versus 2·5 per cent). This translated into a 30-fold lower permanent vocal cord palsy rate (0·02 versus 0·6 per cent). In multivariable logistic regression analysis, continuous IONM independently reduced early postoperative vocal cord palsy 1·8-fold (odds ratio (OR) 0·56) and permanent vocal cord palsy 29·4-fold (OR 0·034) compared with intermittent IONM. One permanent vocal cord palsy per 75·0 early vocal cord palsies was observed with continuous IONM, compared with one per 4·2 after intermittent IONM. Early postoperative vocal cord palsies were 17·9-fold less likely to become permanent with continuous than intermittent IONM. CONCLUSION Continuous IONM is superior to intermittent IONM in preventing vocal cord palsy.
Collapse
Affiliation(s)
- R Schneider
- Department of Visceral, Vascular and Endocrine Surgery, University Hospital, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - A Machens
- Department of Visceral, Vascular and Endocrine Surgery, University Hospital, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - C Sekulla
- Department of Visceral, Vascular and Endocrine Surgery, University Hospital, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - K Lorenz
- Department of Visceral, Vascular and Endocrine Surgery, University Hospital, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - M Elwerr
- Department of Visceral, Vascular and Endocrine Surgery, University Hospital, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - H Dralle
- Department of Visceral, Vascular and Endocrine Surgery, University Hospital, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.,Department of General, Visceral and Transplantation Surgery, Section of Endocrine Surgery, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
12
|
Staubitz JI, Elmrich I, Musholt PB, Cámara RJA, Watzka F, Dralle H, Sekulla C, Lorenz K, Musholt TJ. Targeted use of intraoperative frozen-section analysis lowers the frequency of completion thyroidectomy. BJS Open 2021; 5:6225742. [PMID: 33851986 PMCID: PMC8045471 DOI: 10.1093/bjsopen/zraa058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 11/30/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The impact of intraoperative frozen section (iFS) analysis on the frequency of completion thyroidectomy for the management of thyroid carcinoma is controversial. Although specialized endocrine centres have published their respective results, there are insufficient data from primary and secondary healthcare levels. The aim of this study was to analyse the utility of iFS analysis. METHODS In the Prospective Evaluation Study Thyroid Surgery (PETS) 2 study, 22 011 operations for benign and malignant thyroid disease were registered prospectively in 68 European hospitals from 1 July 2010 to 31 December 2012. Group 1 consisted of 569 patients from University Medical Centre (UMC) Mainz, and group 2 comprised 21 442 patients from other PETS 2 participating hospitals. UMC Mainz exercised targeted but liberal use of iFS analysis for suspected malignant nodules. iFS analysis was compared with standard histological examination regarding the correct distinction between benign and malignant disease. The percentage of completion thyroidectomies was assessed for the participating hospitals. RESULTS iFS analysis was performed in 35.70 per cent of patients in group 1 versus 21.80 per cent of those in group 2 (risk ratio (RR) 1.6, 95 per cent c.i. 1.5 to 1.8; P < 0.001). Sensitivity of iFS analysis was 75.0 per cent in group 1 versus 63.50 per cent in group 2 (RR 1.2, 1.2 to 1.3; P = 0.040). Completion surgery was necessary in 8.10 per cent of patients in group 1 versus 20.8 per cent of those in group 2 (RR 0.4, 0.2 to 0.7; P = 0.001). CONCLUSION iFS analysis is a useful tool in determining the appropriate surgical management of thyroid disease. Targeted use of iFS was associated with a significantly higher sensitivity for the detection of malignancy, and with a significantly reduced necessity for completion surgery.
Collapse
Affiliation(s)
- J I Staubitz
- Section of Endocrine Surgery, Department of General, Visceral and Transplantation Surgery, University Medical Centre Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - I Elmrich
- Section of Endocrine Surgery, Department of General, Visceral and Transplantation Surgery, University Medical Centre Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - P B Musholt
- Section of Endocrine Surgery, Department of General, Visceral and Transplantation Surgery, University Medical Centre Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - R J A Cámara
- Institute for Medical Biometry, Epidemiology and Informatics, University Medical Centre Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - F Watzka
- Section of Endocrine Surgery, Department of General, Visceral and Transplantation Surgery, University Medical Centre Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - H Dralle
- Department of General, Visceral and Transplantation Surgery, University Medical Centre Essen, University Duisburg-Essen, Essen, Germany
| | - C Sekulla
- Department of Visceral, Vascular and Endocrine Surgery, University Medical Centre Halle (Saale), Martin Luther University Halle-Wittenberg, Halle, Germany
| | - K Lorenz
- Department of Visceral, Vascular and Endocrine Surgery, University Medical Centre Halle (Saale), Martin Luther University Halle-Wittenberg, Halle, Germany
| | - T J Musholt
- Section of Endocrine Surgery, Department of General, Visceral and Transplantation Surgery, University Medical Centre Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | | |
Collapse
|
13
|
Fitzal F, Bolliger M, Dunkler D, Gambone L, Heil J, Riedel F, de Boniface J, André C, Matrai Z, Pukancsik D, Paulinelli R, Ostapenko V, Burneckis A, Ostapenko A, Ostapenko E, Meani F, Harder Y, Bonollo M, Alberti A, Tausch C, Papassotiropoulos B, Helfgott R, Heck D, Fehrer H, Acko M, Schrenk P, Montagna G, Trapp E, Pristauz G, Paliczek C, Blohmer J, Steffen S, Romics L, Morrow E, Lorenz K, Fehr M, Ritter M, Weber W. Retrospective multicenter analysis comparing conventional with oncoplastic breast conservation: oncologic and surgical outcome in women with high risk breast cancer from the OPBC-01/iTOP2 study. Breast 2021. [DOI: 10.1016/s0960-9776(21)00222-8] [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: 10/21/2022] Open
|
14
|
Magalhães S, Cabaço JS, Mateus R, Faye DN, Pereira DR, Peres M, Lorenz K, Díaz-Guerra C, Araújo JP, Alves E. Crystal mosaicity determined by a novel layer deconvolution Williamson–Hall method. CrystEngComm 2021. [DOI: 10.1039/d0ce01669a] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
An improvement to the classical Williamson–Hall method is developed to study several samples of AlGaN and α-MoO3.
Collapse
Affiliation(s)
- S. Magalhães
- IPFN, Instituto de Plasmas e Fusão Nuclear
- Campus Tecnológico e Nuclear
- Instituto Superior Técnico
- Universidade de Lisboa
- 2695-066 Bobadela LRS
| | - J. S. Cabaço
- IFIMUP/IN, Instituto de Física dos Materiais da Faculdade de Ciências da Universidade do Porto, Instituto de Nanociência e Nanotecnologia
- 687 4169-007 Porto
- Portugal
| | - R. Mateus
- IPFN, Instituto de Plasmas e Fusão Nuclear
- Campus Tecnológico e Nuclear
- Instituto Superior Técnico
- Universidade de Lisboa
- 2695-066 Bobadela LRS
| | - D. Nd. Faye
- IPFN, Instituto de Plasmas e Fusão Nuclear
- Campus Tecnológico e Nuclear
- Instituto Superior Técnico
- Universidade de Lisboa
- 2695-066 Bobadela LRS
| | - D. R. Pereira
- IPFN, Instituto de Plasmas e Fusão Nuclear
- Campus Tecnológico e Nuclear
- Instituto Superior Técnico
- Universidade de Lisboa
- 2695-066 Bobadela LRS
| | - M. Peres
- IPFN, Instituto de Plasmas e Fusão Nuclear
- Campus Tecnológico e Nuclear
- Instituto Superior Técnico
- Universidade de Lisboa
- 2695-066 Bobadela LRS
| | - K. Lorenz
- IPFN, Instituto de Plasmas e Fusão Nuclear
- Campus Tecnológico e Nuclear
- Instituto Superior Técnico
- Universidade de Lisboa
- 2695-066 Bobadela LRS
| | - C. Díaz-Guerra
- Departamento de Física de Materiales
- Facultad de Ciencias Físicas
- Universidad Complutense de Madrid
- Madrid
- Spain
| | - J. P. Araújo
- IFIMUP/IN, Instituto de Física dos Materiais da Faculdade de Ciências da Universidade do Porto, Instituto de Nanociência e Nanotecnologia
- 687 4169-007 Porto
- Portugal
| | - E. Alves
- IPFN, Instituto de Plasmas e Fusão Nuclear
- Campus Tecnológico e Nuclear
- Instituto Superior Técnico
- Universidade de Lisboa
- 2695-066 Bobadela LRS
| |
Collapse
|
15
|
Klapproth E, Kuenzel S, Guenscht M, Lorenz K, Weber S, Guan K, El-Armouche A. ADAM10 inhibition improves survival and augments cardiac function after myocardial infarction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background and purpose
Following myocardial infarction (MI), adverse fibrotic remodeling with extensive deposition of extracellular matrix (ECM) components has substantial consequences for the contractility of the ventricle finally leading to terminal heart failure (HF). Recently, inhibition of ECM-remodeling enzymes is discussed as potential treatment option for HF, especially following MI. The metalloprotease ADAM10 plays a crucial role in the development of the cardiovascular system and HF patients show elevated serum levels of the ADAM10 substrates CXCL16 and FasL. However, the causal role of ADAM10 in cardiovascular diseases has not been investigated. Here we evaluate the so far unknown role of ADAM10 in heart failure and after MI.
Methods and results
Our study capitalized from human atrial tissue biopsies, a cardiomyocyte-specific ADAM10 knockout (ADAM10 KO) mouse model as well as pharmacological ADAM10 inhibition following MI. ADAM10 expression analysis revealed elevated protein levels in HF patients compared to non-failing hearts. Upon MI, ADAM10 KO and pharmacological ADAM10 inhibition (GI254023X) significantly improved overall survival, significantly enhanced cardiac function (fractional area shortening - FAS, ejection fraction - EF) and significantly reduced infarct sizes. Compared to the high potential angiotensin receptor neprilysin inhibitor (ARNi) LCZ696, ADAM10 inhibition and combined ADAM10i/LCZ696 treatment resulted in preservation of cardiac function that was superior to sole LCZ696 treatment. Mechanistically, this functional improvement was due to reduced shedding of the ADAM10 substrate Notch1, induction of angiogenesis and an ADAM10-dependend inactivation of the NLRP3 inflammasome
Conclusion
Our data suggest that ADAM10 targeting is highly efficient for improving post-infarction cardiac function. Due to its overexpression in heart tissue of HF patients, ADAM10 could be a potential molecular target to improve therapy after MI. In terms of overall survival and pathophysiological remodeling following MI, our data suggest a greater potential of the ADAM10i/LCZ696 combinatorial therapy than sole LCZ696 treatment.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): German Heart Foundation/ German Foundation of Heart Research
Collapse
Affiliation(s)
- E Klapproth
- Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Institute of Pharmacology and Toxicology, Dresden, Germany
| | - S Kuenzel
- Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Institute of Pharmacology and Toxicology, Dresden, Germany
| | - M Guenscht
- Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Institute of Pharmacology and Toxicology, Dresden, Germany
| | - K Lorenz
- University of Wuerzburg, Institute of Pharmacology and Toxicology, Wuerzburg, Germany
| | - S Weber
- Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Institute of Pharmacology and Toxicology, Dresden, Germany
| | - K Guan
- Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Institute of Pharmacology and Toxicology, Dresden, Germany
| | - A El-Armouche
- Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Institute of Pharmacology and Toxicology, Dresden, Germany
| |
Collapse
|
16
|
Branco AC, Silva R, Jorge H, Santos T, Lorenz K, Polido M, Colaço R, Serro AP, Figueiredo-Pina CG. Tribological performance of the pair human teeth vs 3D printed zirconia: An in vitro chewing simulation study. J Mech Behav Biomed Mater 2020; 110:103900. [PMID: 32957205 DOI: 10.1016/j.jmbbm.2020.103900] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 05/04/2020] [Accepted: 05/30/2020] [Indexed: 11/17/2022]
Abstract
This study aims to evaluate the tribological performance of the pair human teeth/robocasted zirconia, with a special focus on the enamel wear mechanisms. Zirconia pieces produced by robocasting (RC) and unidirectional compression (UC) were compared in terms of crystalline structure, density, porosity, hardness and toughness. Chewing simulation tests were performed against human dental cusps. The cusps wear was quantified and the wear mechanisms identified. Although most of the properties of UC and RC samples are similar, differences were observed for surface roughness and porosity. Although the samples did not suffer wear, the antagonist cusps worn in a similar way. In conclusion, robocasting seems a promising technique to produce customized zirconia dental pieces, namely in what concerns the overall tribological behaviour.
Collapse
Affiliation(s)
- A C Branco
- CQE, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal; CDP2T, Escola Superior de Tecnologia de Setúbal, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - R Silva
- CQE, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - H Jorge
- Centro Tecnológico da Cerâmica e Do Vidro (CTCV), Coimbra, Portugal
| | | | - K Lorenz
- INESC-MN, IPFN, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - M Polido
- CiiEM, Escola Superior de Saúde Egas Moniz, Monte de Caparica, Portugal
| | - R Colaço
- IDMEC e Departamento de Engenharia Mecânica, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - A P Serro
- CQE, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal; CiiEM, Escola Superior de Saúde Egas Moniz, Monte de Caparica, Portugal.
| | - C G Figueiredo-Pina
- CDP2T, Escola Superior de Tecnologia de Setúbal, Instituto Politécnico de Setúbal, Setúbal, Portugal; CiiEM, Escola Superior de Saúde Egas Moniz, Monte de Caparica, Portugal; CeFEMA, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| |
Collapse
|
17
|
Abstract
Intraoperative parathyroid hormone (IOPTH) determination is based on the short half-life of parathyroid hormone (PTH) and the rapid analytical technology. The IOPTH provides functional information regarding correction of the overproductive state in hyperparathyroidism (HPT) and is superior to macroscopic evaluation of the parathyroid gland (PG) as well as any (intraoperative frozen section) form of histology (so-called biochemical frozen section). In this article the relevance and evaluation of IOPTH is defined for the most important forms of HPT, for primary HPT, renal secondary and tertiary HPT, multiple endocrine neoplasia type 1 (MEN1) and parathyroid carcinoma and clinical scenarios based on the currently available data. It becomes apparent that the additional benefits of IOPTH depend on diverse prerequisites of the specific type of HPT, the diagnostics as well as individual patient factors and strategic considerations for resection. Overall, the costs for IOPTH are comparably low and seem to be justified with respect to the gain in quality. In the hands of specialized endocrine surgeons IOPTH is an essential tool for intraoperative decision-making and quality assurance.
Collapse
Affiliation(s)
- K Lorenz
- Klinik für Viszeral‑, Gefäß- und Endokrine Chirurgie, Universitätsklinikum Halle, Martin-Luther Universität Halle-Wittenberg, Ernst-Grube-Straße 40, 06120, Halle an der Saale, Deutschland.
| | - R Schneider
- Klinik für Viszeral‑, Gefäß- und Endokrine Chirurgie, Universitätsklinikum Halle, Martin-Luther Universität Halle-Wittenberg, Ernst-Grube-Straße 40, 06120, Halle an der Saale, Deutschland
| | - M Elwerr
- Klinik für Viszeral‑, Gefäß- und Endokrine Chirurgie, Universitätsklinikum Halle, Martin-Luther Universität Halle-Wittenberg, Ernst-Grube-Straße 40, 06120, Halle an der Saale, Deutschland
| |
Collapse
|
18
|
Branco A, Silva R, Santos T, Jorge H, Rodrigues A, Fernandes R, Bandarra S, Barahona I, Matos A, Lorenz K, Polido M, Colaço R, Serro A, Figueiredo-Pina C. Suitability of 3D printed pieces of nanocrystalline zirconia for dental applications. Dent Mater 2020; 36:442-455. [PMID: 32001023 DOI: 10.1016/j.dental.2020.01.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/05/2019] [Accepted: 01/14/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVES The main goal of this work is to evaluate the suitability of nanostructured zirconia pieces obtained by robocasting additive manufacturing (AM), for dental applications. METHODS The density, crystalline structure, morphology/porosity, surface roughness, hardness, toughness, wettability and biocompatibility of the produced samples were compared with those of samples obtained by conventional subtractive manufacturing (SM) of a similar commercial zirconia material. Chewing simulation studies were carried out against dental human cusps in artificial saliva. The wear of the material was quantified and the wear mechanisms investigated, as well as the influence of glaze coating. RESULTS AM samples, that revealed to be biocompatible, are slightly less dense and more porous than SM samples, showing lower hardness, toughness and wettability than SM samples. After chewing tests, no wear was found both on AM and SM samples. However, the dental wear was significantly lower when AM samples were used as counterbody. Concerning the glazed samples, both coated surfaces and dental cusps suffered wear, being the cusps' wear higher than that found for unglazed samples. More, cusps tested against AM coated samples suffered less wear comparatively to those opposed to SM coated samples. SIGNIFICANCE Overall, the results presented in this paper show that AM processed nanostructured zirconia can be used in dental restorations, with important advantages from the point of view of processing and tribological performance. Moreover, the option for glaze finishing should be carefully considered both in SM and AM processed specimens.
Collapse
|
19
|
Machens A, Lorenz K, Dralle H. Prediction of biochemical cure in patients with medullary thyroid cancer. Br J Surg 2020; 107:695-704. [PMID: 32108330 DOI: 10.1002/bjs.11444] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/06/2019] [Accepted: 11/02/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND The impact of number of node metastases versus metastatic lymph node ratio versus AJCC node category on biochemical cure in medullary thyroid cancer (MTC) is not well defined. METHODS Multivariable logistic regression analysis was used to determine clinical and histopathological variables that contribute to biochemical cure in node-positive MTC. RESULTS Some 584 of 1026 patients with MTC underwent systematic lymph node dissections for node-positive disease; 27·4 per cent (54 of 197) were biochemically cured after the initial operation and 13·5 per cent (42 of 310 patients) after repeat surgery. Cured patients had significantly less extrathyroid extension (11-14 versus 33·2-55·6 per cent), fewer lymph node metastases (median 2-4 versus 12-16), a lower metastatic lymph node ratio (median 0·05-0·08 versus 0·23-0·28), and were less likely to have AJCC pN1b disease (56-76 versus 89·9-91·6 per cent) and distant metastases (0 versus 28·4-37·1 per cent) than patients who were not cured. Biochemical cure curves advanced steadily up to 7-12 node metastases and a metastatic lymph node ratio of 0·33, eventually levelling off after 16-17 node metastases and metastatic lymph node ratios of 0·45-0·65. In logistic regression analysis, number of lymph node metastases (odds ratio (OR) 17·24 for more than 20 metastases, OR 5·28 for 11-20 metastases, OR 2·22 for 6-10 metastases), preoperative basal serum calcitonin (OR 6·24 for over 1000 pg/ml), reoperation (OR 5·34) and extrathyroid extension (OR 2·42) independently predicted failure to reach biochemical cure. CONCLUSION Number of lymph node metastases, unlike metastatic lymph node ratio or AJCC node category, determines likelihood of biochemical cure after initial and repeat surgery for node-positive MTC.
Collapse
Affiliation(s)
- A Machens
- Medical Faculty, Department of Visceral, Vascular and Endocrine Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), University of Duisburg-Essen, Essen, Germany
| | - K Lorenz
- Medical Faculty, Department of Visceral, Vascular and Endocrine Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), University of Duisburg-Essen, Essen, Germany
| | - H Dralle
- Medical Faculty, Department of Visceral, Vascular and Endocrine Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), University of Duisburg-Essen, Essen, Germany.,Department of General, Visceral and Transplantation Surgery, Section of Endocrine Surgery, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
20
|
Narayan SS, Lorenz K, Ukkat J, Hoang-Vu C, Trojanowicz B. Angiotensin converting enzymes ACE and ACE2 in thyroid cancer progression. Neoplasma 2019; 67:402-409. [PMID: 31847529 DOI: 10.4149/neo_2019_190506n405] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 07/21/2019] [Indexed: 11/08/2022]
Abstract
Angiotensin-converting enzymes, ACE and ACE2, play not only a pivotal role in the regulation of blood pressure, but are involved in the processes of pathophysiology, including thyroid dysfunction or progression of several neoplasia such as cancers of skin, lungs, pancreas and leukemia. However, their role in the thyroid carcinogenesis remains unknown. We examined in this study the expression of ACE and ACE2 in thyroid tissues and their possible employment as biomarkers for thyroid cancer progression. Thyroid tissues, including 14 goiters (G), 12 follicular adenomas (FA), 10 follicular thyroid carcinomas (FTC), 14 papillary thyroid carcinomas (PTC) and 11 undifferentiated thyroid carcinomas (UTC), were subjected to RT-PCR and protein analyses with primers or antibodies specific for ACE and ACE2, respectively. FA revealed significantly increased ACE compared to other groups and FTC was significantly higher than UTC. ACE2 was significantly increased in PTC in comparison to G, FA and UTC, and in FTC as compared to G. The ratio ACE/ACE2 decreased, while ACE2/ACE increased with the differentiation grade of thyroid carcinoma. ACE was significantly diminished in individuals older than 50. Both ACEs were significantly diminished in M1 patients, ACE2 additionally in higher tumor masses. ACE and ACE2 are regulated within thyroid benign and malignant tissues. As the transcript ratio between both enzymes correlate proportional with the differentiation status of thyroid cancer, ACE and ACE2 may serve as new markers for thyroid carcinoma.
Collapse
Affiliation(s)
- S Satya Narayan
- Department of Visceral, Vascular and Endocrine Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - K Lorenz
- Department of Visceral, Vascular and Endocrine Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - J Ukkat
- Department of Visceral, Vascular and Endocrine Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - C Hoang-Vu
- Department of Visceral, Vascular and Endocrine Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - B Trojanowicz
- Department of Internal Medicine II, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| |
Collapse
|
21
|
Abstract
Ectopic thyroid tissue results from developmental defects of the early stages of thyroid embryogenesis, in which the median thyroid anlage descends from the floor of the mouth to its final pre-tracheal position. The most common sites of ectopic thyroid tissue are accordingly in the area of the floor of the mouth and in the course of the thyroglossal duct. Rare localizations are intrathoracic (mediastinal, cardiac, pulmonary) and sub-diaphragmatic (including the adrenals, liver, gall bladder, and gastrointestinal tract). The most important differential diagnosis of ectopic thyroid is metastasis of differentiated thyroid carcinoma.By contrast, the term parathyroidectopy is not uniformly defined. Usually, the cervical-central localizations are referred to as "positional variants" (with the exception of the maxillary sinus and high parapharyngeal), whereas the cervical-lateral localizations (carotid sheath, vagus nerve) and those below the brachiocephalic and mediastinal positions (extraligamentary, aortopulmonary window, paravagal) and other rare localizations are classified as "ectopic parathyroid tissue". Parathyroidectomy is very common (in autopsy studies in 28 to 42.8% of all humans). In the context of primary hyperparathyroidism (pHPT), there is a prevalence of 6.3 to 16% of ectopic hyperfunctional parathyroid tissue (predominantly adenomas), which play an important role in the surgical treatment of pHPT.
Collapse
Affiliation(s)
- S Theurer
- Institut für Pathologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Deutschland
| | - U Siebolts
- Institut für Pathologie, Universitätsklinikum Halle, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
| | - K Lorenz
- Klinik und Poliklinik für Viszeral‑, Gefäß- und Endokrine Chirurgie, Universitätsklinikum Halle, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
| | - H Dralle
- Klinik für Allgemeinchirurgie, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland
| | - K W Schmid
- Institut für Pathologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Deutschland.
| |
Collapse
|
22
|
Abstract
The therapies available for the rare tumor entity of cervical paraganglioma (PG) are currently undergoing a paradigm shift. The treatment of choice for small carotid body tumors, malignant and active endocrine tumors is surgical resection; however, for locally advanced carotid body tumors and vagal PG, surgical therapy should be critically evaluated. Due to the immediate proximity of these hypervascularized tumors to the caudal cranial nerves, there is a risk of severe nerve damage with a significant impairment of quality of life after resection, particularly for locally advanced cervical PG, emphasizing further the importance of a restrictive surgical strategy. External radiotherapy can provide an equivalent primary therapeutic option with respect to the rate of recurrence and is accompanied by a lower morbidity. The slow rate of tumor progression and the multifocality of the familial variant of cervical PG or significant comorbidities in older, asymptomatic patients warrant a less aggressive treatment strategy for these tumors. When a wait and scan approach is implemented, a closely monitored radiological and clinical re-evaluation is of upmost importance. In a multidisciplinary approach the following critical points require consideration before a therapy is implemented,: size and location of the tumor, progression rate, genetic background, patient age and general condition, relevant comorbidities, the presence of synchronous PG and/or vasoactive catecholamine-producing tumors. Although best practice algorithms for the treatment of cervical PG have already been devised, recent innovative developments have led to more patient-tailored, individualized treatment approaches.
Collapse
Affiliation(s)
- R Schneider
- Universitätsklinik und Poliklinik für Viszerale, Gefäß und Endokrine Chirurgie, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle/Saale, Deutschland.
| | - M Elwerr
- Universitätsklinik und Poliklinik für Viszerale, Gefäß und Endokrine Chirurgie, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle/Saale, Deutschland
| | - K Lorenz
- Universitätsklinik und Poliklinik für Viszerale, Gefäß und Endokrine Chirurgie, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle/Saale, Deutschland
| | - S Plontke
- Universitätsklinik und Poliklinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Halschirurgie, Martin-Luther-Universität, Halle/Saale, Deutschland
| | - H Dralle
- Sektion Endokrine Chirurgie, Klinik für Allgemeinchirurgie, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen, Essen, Deutschland
| | - J Ukkat
- Universitätsklinik und Poliklinik für Viszerale, Gefäß und Endokrine Chirurgie, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle/Saale, Deutschland
| |
Collapse
|
23
|
Nowotny BM, Basnayake S, Lorenz K, Hall J, Ruddock S, Fennessy G, Cox E, Hodges R, Loh E, Wallace EM. Using medico-legal claims for quality improvement in maternity care: application and revision of an NHSLA coding taxonomy. BJOG 2019; 126:1437-1444. [PMID: 31131503 DOI: 10.1111/1471-0528.15823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To validate the NHSLA maternity claims taxonomy at the level of a single maternity service and assess its ability to direct quality improvement. DESIGN Qualitative descriptive study. SETTING Medico-legal claims between 1 January 2000 and 31 December 2016 from a maternity service in metropolitan Melbourne, Australia. POPULATION All obstetric claims and incident notifications occurring within the date range were included for analysis. METHODS De-identified claims and notifications data were derived from the files of the insurer of Victorian public health services. Data included claim date, incident date and summary, and claim cost. All reported issues were coded using the NHSLA taxonomy and the lead issue identified. MAIN OUTCOME MEASURES Rate of claims and notifications, relative frequency of issues, a revised taxonomy. RESULTS A combined total of 265 claims and incidents were reported during the 6 years. Of these 59 were excluded, leaving 198 medico-legal events for analysis (1.66 events/1000 births). The costs for all claims was $46.7 million. The most common claim issues were related to management of labour (n = 63, $17.7 million), cardiotocographic interpretation (n = 43, $24.4 million), and stillbirth (n = 35, $656,750). The original NHSLA classification was not sufficiently detailed to inform care improvement programmes. A revised taxonomy and coding flowchart is presented. CONCLUSIONS Systematic analysis of obstetric medico-legal claims data can potentially be used to inform quality and safety improvement. TWEETABLE ABSTRACT New taxonomy to target health improvement from maternity claims based on NHSLA Ten Years of Maternity Claims.
Collapse
Affiliation(s)
- B M Nowotny
- Department of Obstetrics and Gynaecology, School of Clinical Sciences, The Ritchie Centre, Monash University, Clayton, Vic., Australia.,Safer Care Victoria, Victorian Department of Health and Human Services, Melbourne, Vic., Australia
| | | | - K Lorenz
- Victorian Bar, Melbourne, Vic., Australia
| | - J Hall
- Maryborough District Health Service, Maryborough, Vic., Australia
| | - S Ruddock
- Monash Health, Clayton, Vic., Australia
| | - G Fennessy
- Victorian Managed Insurance Authority, Melbourne, Vic., Australia
| | - E Cox
- Victorian Managed Insurance Authority, Melbourne, Vic., Australia
| | - R Hodges
- Department of Obstetrics and Gynaecology, School of Clinical Sciences, The Ritchie Centre, Monash University, Clayton, Vic., Australia.,Monash Health, Clayton, Vic., Australia
| | - E Loh
- St Vincent's Health Australia, East Melbourne, Vic., Australia
| | - E M Wallace
- Department of Obstetrics and Gynaecology, School of Clinical Sciences, The Ritchie Centre, Monash University, Clayton, Vic., Australia.,Safer Care Victoria, Victorian Department of Health and Human Services, Melbourne, Vic., Australia
| |
Collapse
|
24
|
Musholt TJ, Bockisch A, Clerici T, Dotzenrath C, Dralle H, Goretzki PE, Hermann M, Holzer K, Karges W, Krude H, Kussmann J, Lorenz K, Luster M, Niederle B, Nies C, Riss P, Schabram J, Schabram P, Schmid KW, Simon D, Spitzweg C, Steinmüller T, Trupka A, Vorländer C, Weber T, Bartsch DK. [Update of the S2k guidelines : Surgical treatment of benign thyroid diseases]. Chirurg 2019; 89:699-709. [PMID: 29876616 DOI: 10.1007/s00104-018-0653-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [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: 12/31/2022]
Abstract
Thyroid resections represent one of the most common operations with 76,140 interventions in the year 2016 in Germany (source Destatis). These are predominantly benign thyroid gland diseases. Recommendations for the operative treatment of benign thyroid diseases were last published by the CAEK in 2010 as S2k guidelines (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V. [AWMF] 003/002) against the background of increasingly more radical resection procedures. Hemithyroidectomy and thyroidectomy are routinely performed for benign thyroid disease in practice. The operation-specific risks show a clear increase with the extent of the resection. Therefore, weighing-up of the risk-indications ratio between unilateral lobectomy or thyroidectomy necessitates an independent evaluation of the indications for both sides. This principle in particular has been used to update the guidelines. In addition, the previously published recommendations of the CAEK for correct execution and consequences of intraoperative neuromonitoring were included into the guidelines, which in particular serve the aim to avoid bilateral recurrent laryngeal nerve paralysis. Moreover, the recommendations for the treatment of postoperative complications, such as hypoparathyroidism and postoperative infections were revised. The updated guidelines therefore represent the current state of the science as well as the resulting surgical practice.
Collapse
Affiliation(s)
- T J Musholt
- Sektion Endokrine Chirurgie der Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Universitätsmedizin der Johannes Gutenberg Universität Mainz, Langenbeckstr. 1, 55101, Mainz, Deutschland.
| | - A Bockisch
- Klinik für Nuklearmedizin, Universitätsklinikum Essen, Hufelandstr. 55, 45147, Essen, Deutschland
| | - T Clerici
- Klinik für Chirurgie, Kantonsspital St. Gallen, 9007, St. Gallen, Schweiz
| | - C Dotzenrath
- Klinik für endokrine Chirurgie, Helios Universitätsklinikum Wuppertal, Heusnerstr. 40, 42283, Wuppertal, Deutschland
| | - H Dralle
- Sektion Endokrine Chirurgie, Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen, Hufelandstr. 55, 45147, Essen, Deutschland
| | - P E Goretzki
- Chirurgische Klinik, Campus Charite Mitte/Campus Virchow Klinikum, Endokrine Chirurgie, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - M Hermann
- 2. Chirurgische Abteilung, Krankenanstalt Rudolfstiftung, Märzstr. 80, 1150, Wien, Österreich
| | - K Holzer
- Sektion Endokrine Chirurgie der Viszeral‑, Thorax- u. Gefäßchirurgie, Universitätsklinikum Marburg, Baldingerstr., 35043, Marburg, Deutschland
| | - W Karges
- Sektion Endokrinologie und Diabetologie - Medizinische Klinik III, Universitätsklinikum Aachen, RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - H Krude
- Klinik für Pädiatrie mit Schwerpunkt Endokrinologie und Diabetologie, Charité Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - J Kussmann
- Klinik für Endokrine Chirurgie, Schön Klinik Hamburg-Eilbeck, Dehnhaide 120, 22081, Hamburg, Deutschland
| | - K Lorenz
- Klinik u. Poliklinik f. Allgem.-, Viszeral- u. Gefäßchirurgie, Universitätsklinikum Halle, Ernst-Grube-Str. 40, 06120, Halle, Deutschland
| | - M Luster
- Nuklearmedizin, Universitätsklinikum Gießen und Marburg, GmbH, Standort Marburg, Baldingerstrass, 35041, Marburg, Deutschland
| | - B Niederle
- Sektion Endokrine Chirurgie, Franziskus Spital, Nikolsdorfergasse 32, 1050, Wien, Österreich
| | - C Nies
- Klinik für Allg.- u. Viszeralchirurgie, Marienhospital Osnabrück, Bischofsstr. 1, 49074, Osnabrück, Deutschland
| | - P Riss
- Chirurgische Universitätsklinik, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - J Schabram
- Klinik für Endokrine Chirurgie, Asklepios Klinik Lich, Goethestr. 4, 35423, Lich, Deutschland
| | - P Schabram
- Anwaltskanzlei Ratajczak & Partner, Heinrich-von-Stephan-Str. 25, 79100, Freiburg im Breisgau, Deutschland
| | - K W Schmid
- Pathologie, Universitätsklinikum Essen, Hufelandstr. 55, 45147, Essen, Deutschland
| | - D Simon
- Klinik f. Allg.- u. Viszeralchirurgie, Ev. Bethesda Krankenhaus Duisburg GmbH, Heerstr. 219, 47053, Duisburg, Deutschland
| | - Ch Spitzweg
- Medizinische Klinik und Poliklinik II, LMU Klinikum der Universität München - Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland
| | - Th Steinmüller
- Chirurgische Abteilung, Zentrum f. Allg.- u. Viszeralchirurgie, DRK-Kliniken Westend, Spandauer Damm 130, 14050, Berlin, Deutschland
| | - A Trupka
- Chirurgische Klinik, Klinikum Starnberg GmbH, Oßwaldstr. 1, 82319, Starnberg, Deutschland
| | - C Vorländer
- Endokrine Chirurgie, Bürgerhospital Frankfurt am Main, Nibelungenallee 37-41, 60318, Frankfurt am Main, Deutschland
| | - T Weber
- Klinik für Endokrine Chirurgie, Katholisches Klinikum Mainz, An der Goldgrube 11, 55131, Mainz, Deutschland
| | - D K Bartsch
- Klinik für Visceral‑, Thorax- und Gefäßchirurgie, Universitätsklinikum Gießen und Marburg, GmbH, Standort Marburg, Baldingerstrass, 35041, Marburg, Deutschland
| | | |
Collapse
|
25
|
Lorenz K, Langer P, Niederle B, Alesina P, Holzer K, Nies C, Musholt T, Goretzki PE, Rayes N, Quinkler M, Waldmann J, Simon D, Trupka A, Ladurner R, Hallfeldt K, Zielke A, Saeger D, Pöppel T, Kukuk G, Hötker A, Schabram P, Schopf S, Dotzenrath C, Riss P, Steinmüller T, Kopp I, Vorländer C, Walz MK, Bartsch DK. Surgical therapy of adrenal tumors: guidelines from the German Association of Endocrine Surgeons (CAEK). Langenbecks Arch Surg 2019; 404:385-401. [PMID: 30937523 DOI: 10.1007/s00423-019-01768-z] [Citation(s) in RCA: 15] [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: 02/14/2019] [Accepted: 02/19/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS Previous guidelines addressing surgery of adrenal tumors required actualization in adaption of developments in the area. The present guideline aims to provide practical and qualified recommendations on an evidence-based level reviewing the prevalent literature for the surgical therapy of adrenal tumors referring to patients of all age groups in operative medicine who require adrenal surgery. It primarily addresses general and visceral surgeons but offers information for all medical doctors related to conservative, ambulatory or inpatient care, rehabilitation, and general practice as well as pediatrics. It extends to interested patients to improve the knowledge and participation in the decision-making process regarding indications and methods of management of adrenal tumors. Furthermore, it provides effective medical options for the surgical treatment of adrenal lesions and balances positive and negative effects. Specific clinical questions addressed refer to indication, diagnostic procedures, effective therapeutic alternatives to surgery, type and extent of surgery, and postoperative management and follow-up regime. METHODS A PubMed research using specific key words identified literature to be considered and was evaluated for evidence previous to a formal Delphi decision process that finalized consented recommendations in a multidisciplinary setting. RESULTS Overall, 12 general and 52 specific recommendations regarding surgery for adrenal tumors were generated and complementary comments provided. CONCLUSION Effective and balanced medical options for the surgical treatment of adrenal tumors are provided on evidence-base. Specific clinical questions regarding indication, diagnostic procedures, alternatives to and type as well as extent of surgery for adrenal tumors including postoperative management are addressed.
Collapse
Affiliation(s)
- K Lorenz
- Universitätsklinikum Halle, Halle/Saale, Germany.
| | | | - B Niederle
- Ordination Siebenbrunnenstrasse, Wien, Austria
| | - P Alesina
- Kliniken Essen-Mitte, Essen, Germany
| | - K Holzer
- Universitätsklinikum Marburg, Marburg, Germany
| | - Ch Nies
- Marienhospital Osnabrück, Osnabrück, Germany
| | - Th Musholt
- Universitatsklinikum Mainz, Mainz, Germany
| | - P E Goretzki
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | - N Rayes
- Universitätsklinikum Leipzig, Leipzig, Germany
| | - M Quinkler
- Endokrinologiepraxis Berlin, Berlin, Germany
| | - J Waldmann
- MIVENDO Klinik Hamburg, Hamburg, Germany
| | - D Simon
- Evangelisches Krankenhaus BETHESDA Duisburg, Duisburg, Germany
| | - A Trupka
- Klinikum Starnberg, Klinikum Starnberg, Germany
| | - R Ladurner
- Ludwig-Maximilians-Universität München, München, Germany
| | - K Hallfeldt
- Ludwig-Maximilians-Universität München, München, Germany
| | - A Zielke
- Diakonie-Klinikum Stuttgart, Stuttgart, Germany
| | - D Saeger
- Universitätsklinikum Hamburg, Hamburg, Germany
| | - Th Pöppel
- Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - G Kukuk
- Universitätsklinikum Bonn, Bonn, Germany
| | - A Hötker
- Universitätsklinikum Zürich, Zürich, Switzerland
| | - P Schabram
- RAE Ratacjzak und Partner, Sindelfingen, Germany
| | - S Schopf
- Krankenhaus Agatharied, Hausham, Germany
| | - C Dotzenrath
- HELIOS Universitätsklinikum Wuppertal, Wuppertal, Germany
| | - P Riss
- Medizinische Universität Wien, Wien, Austria
| | - Th Steinmüller
- Deutsches Rotes Kreuz Krankenhaus Berlin, Berlin, Germany
| | - I Kopp
- AWMF, Frankfurt am Main, Germany
| | - C Vorländer
- Bürgerhospital Frankfurt, Frankfurt am Main, Germany
| | - M K Walz
- Kliniken Essen-Mitte, Essen, Germany
| | - D K Bartsch
- Universitätsklinikum Marburg, Marburg, Germany
| |
Collapse
|
26
|
Machens A, Lorenz K, Dralle H. Time to calcitonin normalization after surgery for node-negative and node-positive medullary thyroid cancer. Br J Surg 2019; 106:412-418. [DOI: 10.1002/bjs.11071] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 07/16/2018] [Accepted: 11/01/2018] [Indexed: 12/18/2022]
Abstract
Abstract
Background
It remains unclear when postoperative serum calcitonin levels should be measured in patients with medullary thyroid cancer (MTC) and, specifically, whether this decision should be based on the preoperative calcitonin level or nodal status.
Methods
A cohort of patients with previously untreated MTC was studied. Kaplan–Meier analyses, stratified by preoperative calcitonin level, nodal status and number of nodal metastases, were performed to determine time to calcitonin normalization after initial surgery, with statistical analysis by means of the log rank test.
Results
Some 213 patients with node-negative and 182 with node-positive MTC were included in the study. Postoperative calcitonin levels normalized in a mean of 3·5 versus 3·7 days respectively among patients with preoperative calcitonin levels of 10–100 pg/ml (P = 0·815); 4·8 versus 5·3 days in those with preoperative calcitonin levels of 100·1–500 pg/ml (P = 0·026); 5·3 versus 9·9 days in patients with preoperative calcitonin levels of 500·1–1000 pg/ml (P = 0·004); and 6·6 versus 57·7 days among those with preoperative calcitonin levels exceeding 1000 pg/ml (P < 0·001). Calcitonin levels normalized in a mean of 4·7 days when nodal metastasis was not present, 5·2 days in those with one to five nodal metastases, 7·0 days in patients with six to ten nodal metastases, and 57·1 days among patients with more than ten nodal metastases. Postoperative calcitonin normalization curves paralleled each other in patients with node-negative MTC, but diverged in those with node-positive disease and with more nodal metastases.
Conclusion
Calcitonin levels typically normalize within 1 week; and within a fortnight in those with node-positive MTC and preoperative calcitonin levels of 500·1–1000 pg/ml. With node-positive MTC and preoperative calcitonin levels exceeding 1000 pg/ml, and with more than ten nodal metastases, calcitonin normalization takes longer.
Collapse
Affiliation(s)
- A Machens
- Medical Faculty, Department of General, Visceral and Vascular Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - K Lorenz
- Medical Faculty, Department of General, Visceral and Vascular Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - H Dralle
- Medical Faculty, Department of General, Visceral and Vascular Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- Department of General, Visceral and Transplantation Surgery, Section of Endocrine Surgery, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
27
|
Schwartz R, Trivedi R, Lorenz K, Zulman D. NEUROLOGIST STRATEGIES FOR OPTIMIZING THE PARKINSON’S DISEASE CLINICAL ENCOUNTER. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1856] [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] Open
Affiliation(s)
- R Schwartz
- VA Palo Alto Health Care System & Stanford School of Medicine
| | | | | | - D Zulman
- Stanford University School of Medicine
| |
Collapse
|
28
|
Redondo-Cubero A, Lorenz K, Palomares FJ, Muñoz A, Castro M, Muñoz-García J, Cuerno R, Vázquez L. Concurrent segregation and erosion effects in medium-energy iron beam patterning of silicon surfaces. J Phys Condens Matter 2018; 30:274001. [PMID: 29794326 DOI: 10.1088/1361-648x/aac79a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We have bombarded crystalline silicon targets with a 40 keV Fe+ ion beam at different incidence angles. The resulting surfaces have been characterized by atomic force, current-sensing and magnetic force microscopies, scanning electron microscopy, and x-ray photoelectron spectroscopy. We have found that there is a threshold angle smaller than 40° for the formation of ripple patterns, which is definitely lower than those frequently reported for noble gas ion beams. We compare our observations with estimates of the value of the critical angle and of additional basic properties of the patterning process, which are based on a continuum model whose parameters are obtained from binary collision simulations. We have further studied experimentally the ripple structures and measured how the surface slopes change with the ion incidence angle. We explore in particular detail the fluence dependence of the pattern for an incidence angle value (40°) close to the threshold. Initially, rimmed holes appear randomly scattered on the surface, which evolve into large, bug-like structures. Further increasing the ion fluence induces a smooth, rippled background morphology. By means of microscopy techniques, a correlation between the morphology of these structures and their metal content can be unambiguously established.
Collapse
Affiliation(s)
- A Redondo-Cubero
- Electronics and Semiconductors Group, Departamento de Física Aplicada, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | | | | | | | | | | | | | | |
Collapse
|
29
|
Theodoraki M, Yerneni S, Lorenz K, Laban S, Schuler P, Brunner C, Hoffmann T, Theodorakis I, Whiteside T. PO-243 Exosomes from plasma of HNSCC patients treated with photodynamic therapy are biomarkers for epithelial-mesenchymal transition. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
|
30
|
Thomusch O, Sekulla C, Billmann F, Seifert G, Dralle H, Lorenz K. Risk profile analysis and complications after surgery for autoimmune thyroid disease. Br J Surg 2018; 105:677-685. [PMID: 29579336 DOI: 10.1002/bjs.10770] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 07/04/2017] [Accepted: 10/25/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Surgical approaches to autoimmune thyroid disease are currently hampered by concerns over postoperative complications. Risk profiles and incidences of postoperative complications have not been investigated systematically, and studies with sufficient power to show valid data have not been performed. METHODS A prospective multicentre European study was conducted between July 2010 and December 2012. Questionnaires were used to collect data prospectively on patients who had surgery for autoimmune thyroid disease and the findings were compared with those of patients undergoing surgery for multinodular goitre. Logistic regression analysis was used to evaluate risk factors for thyroid surgery-specific complications, transient and permanent recurrent laryngeal nerve (RLN) palsy and hypoparathyroidism. RESULTS Data were available for 22 011 patients, of whom 18 955 were eligible for analysis (2488 who had surgery for autoimmune thyroid disease and 16 467 for multinodular goitre). Surgery for multinodular goitre and that for autoimmune thyroid disease did not differ significantly with regard to general complications. With regard to thyroid surgery-specific complications, the rate of temporary and permanent vocal cord palsy ranged from 2·7 to 6·7 per cent (P = 0·623) and from 0·0 to 1·4 per cent (P = 0·600) respectively, whereas the range for temporary and permanent hypoparathyroidism was 12·9 to 20·0 per cent (P < 0·001) and 0·0 to 7·0 per cent (P < 0·001) respectively. In logistic regression analysis of transient and permanent vocal cord palsy, autoimmune thyroid disease was not an independent risk factor. Autoimmune thyroid disease, extent of thyroid resection, number of identified parathyroid glands and no autotransplantation were identified as independent risk factors for both transient and permanent hypoparathyroidism. CONCLUSION Surgery for autoimmune thyroid disease is safe in comparison with surgery for multinodular goitre in terms of general complications and RLN palsy. To avoid the increased risk of postoperative hypoparathyroidism, special attention needs to be paid to the parathyroid glands.
Collapse
Affiliation(s)
- O Thomusch
- Department of General and Visceral Surgery, Albert Ludwig University of Freiburg, Freiburg, Germany
| | - C Sekulla
- Department of General, Vascular and Visceral Surgery, Martin Luther University of Halle-Wittenberg, Halle an der Saale, Germany
| | - F Billmann
- Department of General, Visceral and Transplantation Surgery, University Hospital of Heidelberg, Heidelberg, Germany
| | - G Seifert
- Department of General and Visceral Surgery, Albert Ludwig University of Freiburg, Freiburg, Germany
| | - H Dralle
- Department of General, Vascular and Visceral Surgery, Martin Luther University of Halle-Wittenberg, Halle an der Saale, Germany
| | - K Lorenz
- Department of General, Vascular and Visceral Surgery, Martin Luther University of Halle-Wittenberg, Halle an der Saale, Germany
| |
Collapse
|
31
|
Schneider R, Machens A, Sekulla C, Lorenz K, Weber F, Dralle H. Twenty-year experience of paediatric thyroid surgery using intraoperative nerve monitoring. Br J Surg 2018. [PMID: 29532905 DOI: 10.1002/bjs.10792] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND There are few data on intermittent and continuous intraoperative nerve monitoring (IONM) during thyroidectomy in children. METHODS All children aged 18 years or younger who had standard thyroid operations using intermittent or continuous IONM between January 1998 and December 2016 were included in the study. The impact of age and type of IONM on basal amplitude, latency and complications after thyroidectomy were assessed. RESULTS A total of 504 children were included in the study. With continuous IONM, median basal amplitude and latency increased significantly with age, more on the left side (from 199 to 870 μV, and from 3·88 to 5·75 ms) than on the right (from 340 to 778 μV, and from 2·63 to 3·50 ms). Compared with intermittent IONM with needle electrode, continuous IONM with tube electrode resulted in an increase in median basal amplitude in children aged 13-18 years on both sides (from 675 to 778 μV on the right and from 450 to 870 μV on the left), and a decrease in median latency in all children older than 3 years: in children aged 4-6 years, from 4·20 to 3·00 ms on the right and from 6·10 to 4·63 ms on the left; in children aged 7-12 years, from 4·60 to 3·50 ms and from 6·00 to 5·25 ms respectively; and in children aged 13-18 years, from 4·60 to 3·50 ms and from 6·40 to 5·75 ms. Overall, wound infection, but not bleeding/haematoma or vocal fold palsy, affected younger children more: 3 per cent of children aged 3 years or less; 2 per cent of children aged 4-6 years; and 0 per cent of children aged over 6 years (P = 0·031). With continuous IONM, no wound infection, bleeding/haematoma or permanent vocal fold palsy was noted in any age group. CONCLUSION Continuous IONM measures nerve electrophysiology more accurately than intermittent IONM during thyroidectomy in children.
Collapse
Affiliation(s)
- R Schneider
- Department of General, Visceral and Vascular Surgery, University Hospital, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - A Machens
- Department of General, Visceral and Vascular Surgery, University Hospital, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - C Sekulla
- Department of General, Visceral and Vascular Surgery, University Hospital, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - K Lorenz
- Department of General, Visceral and Vascular Surgery, University Hospital, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - F Weber
- Department of General, Visceral and Transplantation Surgery, Section of Endocrine Surgery, University of Duisburg-Essen, Essen, Germany
| | - H Dralle
- Department of General, Visceral and Vascular Surgery, University Hospital, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.,Department of General, Visceral and Transplantation Surgery, Section of Endocrine Surgery, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
32
|
Hwang YS, Lorenz K. Quality of Malting Barleys Grown at Different Locations in the United States and Canada. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-44-0006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Y. S. Hwang
- Department of Food Science & Human Nutrition, Colorado State University, Fort Collins, CO 80523
| | - K. Lorenz
- Department of Food Science & Human Nutrition, Colorado State University, Fort Collins, CO 80523
| |
Collapse
|
33
|
Machens A, Elwerr M, Lorenz K, Weber F, Dralle H. Long-term outcome of prophylactic thyroidectomy in children carrying RET germline mutations. Br J Surg 2018; 105:e150-e157. [DOI: 10.1002/bjs.10746] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/16/2017] [Accepted: 10/03/2017] [Indexed: 01/10/2023]
Abstract
Abstract
Background
A comprehensive assessment has not been undertaken of long-term outcomes in children carrying germline RET mutations and undergoing prophylactic thyroidectomy with the aim of preventing medullary thyroid cancer (MTC).
Methods
A retrospective outcome study (1994–2017) of prophylactic thyroidectomy in children, with and without central node dissection, was performed at a tertiary surgical centre.
Results
Some 167 children underwent prophylactic thyroidectomy, 109 without and 58 with concomitant central node dissection. In the highest-risk mutational category, MTC was found in five of six children (83 per cent) aged 3 years or less. In the high-risk category, MTC was present in six of 20 children (30 per cent) aged 3 years or less, 16 of 36 (44 per cent) aged 4–6 years, and 11 of 16 (69 per cent) aged 7–12 years (P = 0·081). In the moderate-risk category, MTC was seen in one of nine children (11 per cent) aged 3 years or less, one of 26 (4 per cent) aged 4–6 years, three of 26 (12 per cent) aged 7–12 years, and seven of 16 (44 per cent) aged 13–18 years (P = 0·006). Postoperative hypoparathyroidism was more frequent in older children (32 per cent in the oldest age group versus 3 per cent in the youngest; P = 0·002), whether or not central node dissection was carried out. Three children developed recurrent laryngeal nerve palsy; all had undergone central node dissection (P = 0·040). All complications resolved within 6 months. Postoperative normalization of calcitonin serum levels was achieved in 114 (99·1 per cent) of 115 children with raised preoperative values. No residual structural disease or recurrence was observed.
Conclusion
Early prophylactic thyroidectomy is a viable surgical concept in experienced hands, sparing older children the postoperative morbidity associated with delayed neck surgery.
Collapse
Affiliation(s)
- A Machens
- Department of General, Visceral and Vascular Surgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - M Elwerr
- Department of General, Visceral and Vascular Surgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - K Lorenz
- Department of General, Visceral and Vascular Surgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - F Weber
- Department of General, Visceral and Transplantation Surgery, Section of Endocrine Surgery, University of Duisburg-Essen, Essen, Germany
| | - H Dralle
- Department of General, Visceral and Vascular Surgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- Department of General, Visceral and Transplantation Surgery, Section of Endocrine Surgery, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
34
|
Theodoraki M, Lorenz K, Lotfi R, Fürst D, Tsamadou C, Jaekle S, Mytilineos J, Brunner C, Theodorakis J, Hoffmann T, Laban S, Schuler P. Influence of photodynamic therapy on peripheral immune cell populations and cytokine concentrations in head and neck cancer. Photodiagnosis Photodyn Ther 2017; 19:194-201. [DOI: 10.1016/j.pdpdt.2017.05.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 05/02/2017] [Accepted: 05/18/2017] [Indexed: 12/23/2022]
|
35
|
Gensler D, Salinger T, Lorenz K, Ertl G, Jakob P, Nordbeck P. 4100Selective TRASSI T1 mapping for improved endocardial and right ventricular diagnostics. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.4100] [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: 11/13/2022] Open
|
36
|
Kazakov A, Trouvain A, Hall R, Werner C, Rodionycheva S, Lammert F, Maack C, Lorenz K, Boehm M, Laufs U. P1585Fibrotic myocardial remodeling is regulated by rkip and nrf2 depending on redox status. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1585] [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: 11/13/2022] Open
|
37
|
Oder D, Liu D, Hu K, Salinger T, Muentze J, Lorenz K, Ertl G, Wanner C, Nordbeck P. P1102Role of serum biomarkers for monitoring disease progression in the cardio-specific alpha-galactosidase A genotype N215S. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1102] [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: 11/13/2022] Open
|
38
|
Noack B, Kipping T, Tervahartiala T, Sorsa T, Hoffmann T, Lorenz K. Association between serum and oral matrix metalloproteinase-8 levels and periodontal health status. J Periodontal Res 2017; 52:824-831. [DOI: 10.1111/jre.12450] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2016] [Indexed: 01/22/2023]
Affiliation(s)
- B. Noack
- Department of Periodontology; Medical Faculty Carl Gustav Carus; TU Dresden; Dresden Germany
| | - T. Kipping
- Department of Periodontology; Medical Faculty Carl Gustav Carus; TU Dresden; Dresden Germany
| | - T. Tervahartiala
- Department of Oral and Maxillofacial Diseases; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - T. Sorsa
- Department of Oral and Maxillofacial Diseases; University of Helsinki and Helsinki University Hospital; Helsinki Finland
- Division of Periodontology; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
| | - T. Hoffmann
- Department of Periodontology; Medical Faculty Carl Gustav Carus; TU Dresden; Dresden Germany
| | - K. Lorenz
- Department of Periodontology; Medical Faculty Carl Gustav Carus; TU Dresden; Dresden Germany
| |
Collapse
|
39
|
Carr S, Ritso M, Brand T, Roos A, Lorenz K, Lochmüller H. Studying mdx cardiomyocyte hypertrophy in vitro. Neuromuscul Disord 2017. [DOI: 10.1016/s0960-8966(17)30262-6] [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]
|
40
|
Joa F, Geiser R, Köhler C, Lorenz K, Jany B, Held M. Deeskalation einer initialen Dreifachkombinationstherapie inklusive intravenöser Prostanoidgabe im Verlauf auf eine non-intravenöse Dreifachkombinationstherapie bei iPAH – ein Fallbericht. Pneumologie 2017. [DOI: 10.1055/s-0037-1598400] [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)
- F Joa
- Abteilung Innere Medizin Pneumologie, Klinikum Würzburg Mitte gGmbH
| | - R Geiser
- Abteilung Innere Medizin Pneumologie, Klinikum Würzburg Mitte gGmbH
| | - C Köhler
- Abteilung Innere Medizin Pneumologie, Klinikum Würzburg Mitte gGmbH
| | - K Lorenz
- Abteilung Innere Medizin Pneumologie, Klinikum Würzburg Mitte gGmbH
| | - B Jany
- Abteilung Innere Medizin Pneumologie, Klinikum Würzburg Mitte gGmbH
| | - M Held
- Abteilung Innere Medizin Pneumologie, Klinikum Würzburg Mitte gGmbH
| |
Collapse
|
41
|
Singh AK, O'Donnell KP, Edwards PR, Lorenz K, Kappers MJ, Boćkowski M. Hysteretic photochromic switching of Eu-Mg defects in GaN links the shallow transient and deep ground states of the Mg acceptor. Sci Rep 2017; 7:41982. [PMID: 28155896 PMCID: PMC5290469 DOI: 10.1038/srep41982] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 10/24/2016] [Accepted: 01/04/2017] [Indexed: 11/30/2022] Open
Abstract
Although p-type activation of GaN by Mg underpins a mature commercial technology, the nature of the Mg acceptor in GaN is still controversial. Here, we use implanted Eu as a ‘spectator ion’ to probe the lattice location of Mg in doubly doped GaN(Mg):Eu. Photoluminescence spectroscopy of this material exemplifies hysteretic photochromic switching (HPS) between two configurations, Eu0 and Eu1(Mg), of the same Eu-Mg defect, with a hyperbolic time dependence on ‘switchdown’ from Eu0 to Eu1(Mg). The sample temperature and the incident light intensity at 355 nm tune the characteristic switching time over several orders of magnitude, from less than a second at 12.5 K, ~100 mW/cm2 to (an estimated) several hours at 50 K, 1 mW/cm2. Linking the distinct Eu-Mg defect configurations with the shallow transient and deep ground states of the Mg acceptor in the Lany-Zunger model, we determine the energy barrier between the states to be 27.7(4) meV, in good agreement with the predictions of theory. The experimental results further suggest that at low temperatures holes in deep ground states are localized on N atoms axially bonded to Mg acceptors.
Collapse
Affiliation(s)
- A K Singh
- SUPA Department of Physics, University of Strathclyde, 107 Rottenrow, Glasgow G4 0NG, Scotland, United Kingdom
| | - K P O'Donnell
- SUPA Department of Physics, University of Strathclyde, 107 Rottenrow, Glasgow G4 0NG, Scotland, United Kingdom
| | - P R Edwards
- SUPA Department of Physics, University of Strathclyde, 107 Rottenrow, Glasgow G4 0NG, Scotland, United Kingdom
| | - K Lorenz
- IPFN, Instituto Superior Técnico, Universidade de Lisboa, Campus Tecnológico e Nuclear, Estrada Nacional 10, 2695-066 Bobadela LRS, Portugal
| | - M J Kappers
- Department of Materials Science and Metallurgy, University of Cambridge, 27 Charles Babbage Road, Cambridge CB3 0FS, England, United Kingdom
| | - M Boćkowski
- Institute of High Pressure Physics PAS, Sokolowska 29/37, 01-142 Warsaw, Poland
| |
Collapse
|
42
|
Vila M, Díaz-Guerra C, Lorenz K, Piqueras J, Píš I, Magnano E, Munuera C, Alves E, García-Hernández M. Effects of thermal annealing on the structural and electronic properties of rare earth-implanted MoO3 nanoplates. CrystEngComm 2017. [DOI: 10.1039/c7ce00242d] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
43
|
Redondo-Cubero A, Galiana B, Lorenz K, Palomares FJ, Bahena D, Ballesteros C, Hernandez-Calderón I, Vázquez L. Self-organised silicide nanodot patterning by medium-energy ion beam sputtering of Si(100): local correlation between the morphology and metal content. Nanotechnology 2016; 27:444001. [PMID: 27670245 DOI: 10.1088/0957-4484/27/44/444001] [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: 06/06/2023]
Abstract
We have produced self-organised silicide nanodot patterns by medium-energy ion beam sputtering (IBS) of silicon targets with a simultaneous and isotropic molybdenum supply. Atomic force microscopy (AFM) studies show that these patterns are qualitatively similar to those produced thus far at low ion energies. We have determined the relevance of the ion species on the pattern ordering and properties. For the higher ordered patterns produced by Xe(+) ions, the pattern wavelength depends linearly on the ion energy. The dot nanostructures are silicide-rich as assessed by x-ray photoelectron spectroscopy (XPS) and emerge in height due to their lower sputtering yield, as observed by electron microscopy. Remarkably, a long wavelength corrugation is observed on the surface which is correlated with both the Mo content and the dot pattern properties. Thus, as assessed by electron microscopy, the protrusions are Mo-rich with higher and more spaced dots on their surface whereas the valleys are Mo-poor with smaller dots that are closer to each other. These findings indicate that there is a correlation between the local metal content of the surface and the nanodot pattern properties both at the nanodot and the large corrugation scales. These results contribute to advancing the understanding of this interesting nanofabrication method and aid in developing a comprehensive theory of nanodot pattern formation and evolution.
Collapse
Affiliation(s)
- A Redondo-Cubero
- Departamento de Física Aplicada, Universidad Autónoma de Madrid, Cantoblanco, 28049 Madrid, Spain
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Abstract
Medullary thyroid carcinoma (MTC) is subdivided into sporadic (75%) and hereditary (25%) forms. Several germline mutations in the RET proto-oncogene are the source of distinct clinical phenotypes in hereditary MTC including familial MTC (FMTC) and multiple endocrine neoplasia 2A (MEN 2A) and 2B (MEN 2B). The higher the penetrance of the MEN 2 phenotype the earlier the progression of MTC which forms the basis for the currently recommended codon-related concept of prophylactic thyroidectomy. In patients with sporadic MTC, routine calcitonin (CT) measurement in nodular goiter patients has been shown to reduce the frequency of advanced tumor stages. Patients with CT levels over 100 pg/ml after pentagastrin stimulation are recommended for total thyroidectomy. In patients with unexpected sporadic MTC after histological examination, completion thyroidectomy is currently only recommended when CT levels remain elevated. The extent of lymph node dissection in patients with MTC is controversial. However, with respect to lymphonodal micrometastases, systematic compartment-oriented microdissection has been shown to reduce the frequency of lymphonodal recurrence. On the other hand, to avoid unnecessary lymph node dissection, a more individualized concept is required in the future. New chemotherapeutic agents (tyrosine kinase inhibitors), therapeutic nuclids (90Yttrium-labeled octreotide), and chemoembolization of liver metastases are currently the most promising therapeutical concepts in patients with distant metastases.
Collapse
Affiliation(s)
- M Brauckhoff
- Department of General, Visceral, and Vascular Surgery, Martin-Luther-University of Halle-Wittenberg, Halle/Saale, Germany.
| | | | | | | | | | | |
Collapse
|
45
|
Elflein HM, Rudy M, Lorenz K, Ponto KA, Scheurich A, Pitz S. Charles Bonnet's syndrome: not only a condition of the elderly. Graefes Arch Clin Exp Ophthalmol 2016; 254:1637-1642. [PMID: 27342586 DOI: 10.1007/s00417-016-3387-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 12/14/2015] [Revised: 05/09/2016] [Accepted: 05/16/2016] [Indexed: 12/01/2022] Open
Abstract
PURPOSE To investigate whether the experience of visual hallucinations, namely Charles Bonnet's syndrome, in psychologically healthy people is a phenomenon solely of elderly, visually impaired people. METHODS In a prospective controlled study, four groups of subjects (total 324) were formed: age ≤40 years, no visual impairment; age ≤40 years, visually impaired; age >40 years, no visual impairment; age >40 years, visually impaired. Visual impairment was defined as best-corrected visual acuity ≤0.3 (Snellen) in the better-seeing eye. Each group consisted of 81 subjects. Visual hallucinations were defined as complex visual perceptions. After ruling out psychiatric causes for visual hallucinations or medication related to the experience of visual hallucinations, affected subjects underwent a detailed interview about their visual hallucinations. RESULTS The prevalence of visual hallucinations among young subjects with visual impairment was 4.9 %; among the elderly visually impaired subjects, it was 6.2 %. The difference was not statistically significant. No subject without visual impairment experienced visual hallucinations. CONCLUSIONS Charles Bonnet's syndrome is not limited to elderly people suffering from visual impairment, though there tends to be a higher prevalence of visual hallucinations in this group.
Collapse
Affiliation(s)
- Heike M Elflein
- Department of Ophthalmology, University Medical Center, Langenbeckstr. 1, 55131, Mainz, Germany.
| | - M Rudy
- Department of Ophthalmology, University Medical Center, Langenbeckstr. 1, 55131, Mainz, Germany
| | - K Lorenz
- Department of Ophthalmology, University Medical Center, Langenbeckstr. 1, 55131, Mainz, Germany
| | - K A Ponto
- Department of Ophthalmology, University Medical Center, Langenbeckstr. 1, 55131, Mainz, Germany.,Center for Thrombosis and Hemostasis (CTH), University Medical Center, Langenbeckstr. 1, 55131, Mainz, Germany
| | - A Scheurich
- Department of Psychiatry and Psychotherapy, University Medical Center, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| | - S Pitz
- Department of Ophthalmology, University Medical Center, Langenbeckstr. 1, 55131, Mainz, Germany
| |
Collapse
|
46
|
Lorenz K, Keller T, Noack B, Freitag A, Netuschil L, Hoffmann T. Evaluation of a novel point-of-care test for active matrix metalloproteinase-8: agreement between qualitative and quantitative measurements and relation to periodontal inflammation. J Periodontal Res 2016; 52:277-284. [DOI: 10.1111/jre.12392] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2016] [Indexed: 02/03/2023]
Affiliation(s)
- K. Lorenz
- Department of Periodontology; Faculty of Medicine Carl Gustav Carus; Technische Universität Dresden; Dresden Germany
| | | | - B. Noack
- Department of Periodontology; Faculty of Medicine Carl Gustav Carus; Technische Universität Dresden; Dresden Germany
| | - A. Freitag
- Department of Periodontology; Faculty of Medicine Carl Gustav Carus; Technische Universität Dresden; Dresden Germany
| | - L. Netuschil
- Department of Periodontology; Faculty of Medicine Carl Gustav Carus; Technische Universität Dresden; Dresden Germany
| | - T. Hoffmann
- Department of Periodontology; Faculty of Medicine Carl Gustav Carus; Technische Universität Dresden; Dresden Germany
| |
Collapse
|
47
|
Schmitt M, Hoffmann JM, Lorenz K, Publicover A, Schmitt A, Nagler A. Mobilization of autologous and allogeneic peripheral blood stem cells for transplantation in haematological malignancies using biosimilar G-CSF. Vox Sang 2016; 111:178-86. [PMID: 27509033 DOI: 10.1111/vox.12397] [Citation(s) in RCA: 24] [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: 06/18/2015] [Revised: 02/05/2016] [Accepted: 02/05/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND OBJECTIVES Biosimilars of the granulocyte colony stimulating factor (G-CSF) filgrastim were approved by the European Medicines Agency (EMA) for registered indications of the originator G-CSF, including prevention and treatment of neutropenia, as well as mobilization of peripheral blood stem cells in 2008. Nevertheless, there is still an ongoing debate regarding the quality, efficacy and safety of biosimilar G-CSF. MATERIALS AND METHODS This article is a meta-analysis of clinical studies on the use of biosimilar G-CSF for mobilization and transplantation of haematopoietic stem cells as available in public databases. All data sets were weighted for the number of patients and parameters and then subjected to statistical meta-analysis employing the Mann-Whitney U-test followed by the Hodges-Lehmann estimator to assess differences between biosimilar and originator G-SCF. RESULTS A total of 1892 individuals, mostly with haematological malignancies but also including 351 healthy donors have been successfully mobilized for autologous or allogeneic stem cell transplantation using biosimilar G-CSF (Zarzio(TM) : 1239 individuals; Ratiograstim(TM) /Tevagrastim(TM) : 653 individuals). A total of 740 patients with multiple myeloma, 491 with non-Hodgkin's lymphoma (NHL), 150 with Hodgkin's lymphoma (HL) and other diseases are included in this meta-analysis, as well as 161 siblings and 190 volunteer unrelated donors. For biosimilar and originator G-CSF, bioequivalence was observed for the yield of CD34+ stem cells as well as for the engraftment of the transplants. CONCLUSION Biosimilar G-CSF has equivalent effects and safety as originator G-CSF.
Collapse
Affiliation(s)
- M Schmitt
- University Clinic Heidelberg, Internal Medicine V (Hematology, Oncology and Rheumatology), University of Heidelberg, Heidelberg, Germany
| | - J-M Hoffmann
- University Clinic Heidelberg, Internal Medicine V (Hematology, Oncology and Rheumatology), University of Heidelberg, Heidelberg, Germany
| | - K Lorenz
- University Clinic Heidelberg, Internal Medicine V (Hematology, Oncology and Rheumatology), University of Heidelberg, Heidelberg, Germany
| | - A Publicover
- Human Dendritic Cell Laboratory, Institute of Cellular Medicine, Newcastle University, Newcastle, UK
| | - A Schmitt
- University Clinic Heidelberg, Internal Medicine V (Hematology, Oncology and Rheumatology), University of Heidelberg, Heidelberg, Germany
| | - A Nagler
- Hematology Division, BMT and Cord Blood Bank, Chaim Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Israel
| |
Collapse
|
48
|
Mitchell B, Timmerman D, Poplawsky J, Zhu W, Lee D, Wakamatsu R, Takatsu J, Matsuda M, Guo W, Lorenz K, Alves E, Koizumi A, Dierolf V, Fujiwara Y. Utilization of native oxygen in Eu(RE)-doped GaN for enabling device compatibility in optoelectronic applications. Sci Rep 2016; 6:18808. [PMID: 26725651 PMCID: PMC4698738 DOI: 10.1038/srep18808] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [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: 07/17/2015] [Accepted: 11/23/2015] [Indexed: 11/25/2022] Open
Abstract
The detrimental influence of oxygen on the performance and reliability of V/III nitride based devices is well known. However, the influence of oxygen on the nature of the incorporation of other co-dopants, such as rare earth ions, has been largely overlooked in GaN. Here, we report the first comprehensive study of the critical role that oxygen has on Eu in GaN, as well as atomic scale observation of diffusion and local concentration of both atoms in the crystal lattice. We find that oxygen plays an integral role in the location, stability, and local defect structure around the Eu ions that were doped into the GaN host. Although the availability of oxygen is essential for these properties, it renders the material incompatible with GaN-based devices. However, the utilization of the normally occurring oxygen in GaN is promoted through structural manipulation, reducing its concentration by 2 orders of magnitude, while maintaining both the material quality and the favorable optical properties of the Eu ions. These findings open the way for full integration of RE dopants for optoelectronic functionalities in the existing GaN platform.
Collapse
Affiliation(s)
- B Mitchell
- Department of Physics and Astronomy, University of Mount. Union, 1972 Clark Ave, Alliance, OH, 44601, USA
| | - D Timmerman
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan
| | - J Poplawsky
- Center for Nanophase Materials Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
| | - W Zhu
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan
| | - D Lee
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan
| | - R Wakamatsu
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan
| | - J Takatsu
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan
| | - M Matsuda
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan
| | - W Guo
- Center for Nanophase Materials Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
| | - K Lorenz
- Instituto Superior Técnico, Campus Tecnológico e Nuclear, Estrada Nacional 10, P-2695-066 Bobadela LRS, Portugal
| | - E Alves
- Instituto Superior Técnico, Campus Tecnológico e Nuclear, Estrada Nacional 10, P-2695-066 Bobadela LRS, Portugal
| | - A Koizumi
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan
| | - V Dierolf
- Department of Physics and Astronomy, Lehigh University, 16 Memorial Dr. E, Bethlehem, PA, 18015, USA
| | - Y Fujiwara
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871, Japan
| |
Collapse
|
49
|
Schneider R, Lorenz K, Sekulla C, Machens A, Nguyen-Thanh P, Dralle H. [Surgical strategy during intended total thyroidectomy after loss of EMG signal on the first side of resection]. Chirurg 2015; 86:154-63. [PMID: 24823999 DOI: 10.1007/s00104-014-2751-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Unambiguous identification of the recurrent laryngeal nerve with detection of nerve dysfunction giving rise to postoperative vocal cord palsy (VCP) is the principal objective of intraoperative neuromonitoring (IONM) in thyroid surgery. Because intraoperative loss of the electromyographic (EMG) signal (LOS) does not result in VCP in one third of patients, controversy surrounds the issue of whether a change in strategy is needed in planned total thyroidectomy after LOS on the first side of resection. PATIENTS AND METHODS This was a retrospective institutional study of 1,049 consecutive patients (2,086 nerves at risk) with intended bilateral thyroid surgery who were operated on between April 2010 and July 2012 with the use of IONM. The rates of temporary and permanent VCP were analyzed on the basis of the IONM results of the first side of resection and the extent of contralateral resection for completion: resection without LOS (group 1); resection with LOS and contralateral thyroidectomy (group 2); resection with LOS and contralateral subtotal resection (group 3); resection with LOS without any contralateral resection (group 4). RESULTS LOS on the first side of resection was noted in 27 patients (2.6 %). All VCPs were unilateral. The rates of temporary and permanent VCP were 2.5 and 0.4 %, respectively, overall; specifically: group 1: 0.5 and 0 %; group 2: 64 and 9.1 %; group 3: 100 and 50 %; group 4: 83 and 8.3 %, respectively. CONCLUSION Because an abnormal intraoperative electromyogram carries an 80 % risk for early postoperative VCP, the initial plan of bilateral surgery needs to be critically reviewed after LOS has occurred on the first side of resection, taking into account the underlying thyroid disease of the patient and surgeon expertise. Since more than 80 % of affected nerves will fully recover after the operation, staged completion thyroidectomy is recommended.
Collapse
Affiliation(s)
- R Schneider
- Universitätsklinik und Poliklinik für Allgemein-, Viszeral- und Gefäßchirurgie, Martin-Luther-Universität, Ernst-Grube-Str. 40, 06120, Halle/Saale, Deutschland,
| | | | | | | | | | | |
Collapse
|
50
|
Redondo-Cubero A, Lorenz K, Wendler E, Magalhães S, Alves E, Carvalho D, Ben T, Morales FM, García R, O'Donnell KP, Wetzel C. Analysis of the stability of InGaN/GaN multiquantum wells against ion beam intermixing. Nanotechnology 2015; 26:425703. [PMID: 26421745 DOI: 10.1088/0957-4484/26/42/425703] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Ion-induced damage and intermixing was evaluated in InGaN/GaN multi-quantum wells (MQWs) using 35 keV N(+) implantation at room temperature. In situ ion channeling measurements show that damage builds up with a similar trend for In and Ga atoms, with a high threshold for amorphization. The extended defects induced during the implantation, basal and prismatic stacking faults, are uniformly distributed across the quantum well structure. Despite the extremely high fluences used (up to 4 × 10(16) cm(-2)), the InGaN MQWs exhibit a high stability against ion beam mixing.
Collapse
Affiliation(s)
- A Redondo-Cubero
- Instituto Superior Técnico, Universidade de Lisboa, Campus Tecnológico e Nuclear, Estrada Nacional 10, 2695-066 Bobadela LRS, Portugal. Departamento de Física Aplicada y Centro de Microanálisis of Materiales, Universidad Autónoma de Madrid, E-28049 Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|