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Yozgatli TK, Bilgin IA, Bengur FB, Bas M, Ozben V, Aytac E, Baca B, Hamzaoglu I, Karahasanoglu T. Simultaneous laparoscopic totally extraperitoneal and transabdominal preperitoneal repair for bilateral inguinal hernia in a patient with a history of robotic prostatectomy - a video vignette. Colorectal Dis 2018; 20:1052-1053. [PMID: 30216630 DOI: 10.1111/codi.14421] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 08/28/2018] [Indexed: 02/08/2023]
Affiliation(s)
- T K Yozgatli
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - I A Bilgin
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - F B Bengur
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - M Bas
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey.,Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - V Ozben
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - E Aytac
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - B Baca
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - I Hamzaoglu
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - T Karahasanoglu
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
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2
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Bengur FB, Bas M, Aktas A, Yozgatli TK, Bilgin IA, Ozben V, Aytac E, Baca B, Hamzaoglu I, Karahasanoglu T. Laparoscopic management of bowel obstruction due to multiple congenital adhesion bands in pregnancy - a video vignette. Colorectal Dis 2018; 20:1051-1052. [PMID: 30194901 DOI: 10.1111/codi.14407] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 08/13/2018] [Indexed: 12/26/2022]
Affiliation(s)
- F B Bengur
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - M Bas
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey.,Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - A Aktas
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey.,Turgut Ozal Medical Center, Inonu University School of Medicine, Malatya, Turkey
| | - T K Yozgatli
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - I A Bilgin
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - V Ozben
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - E Aytac
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - B Baca
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - I Hamzaoglu
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - T Karahasanoglu
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
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3
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Bas M, Cardona L. Effects of skeletal element identity, delipidation and demineralization on the analysis of stable isotope ratios of C and N in fish bone. J Fish Biol 2018; 92:420-437. [PMID: 29235096 DOI: 10.1111/jfb.13521] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 11/14/2017] [Indexed: 06/07/2023]
Abstract
Stable isotope ratios of C and N in the bone tissue of three different skeletal elements (angular, cleithrum and vertebra) of three fish species from different evolutionary lineages (Clupeiformes, Atheriniformes and Notothenioidei) were determined before (δ13 Cbulk and δ15 Nbulk ) and after demineralization and delipidation (δ13 Cdml and δ15 Ndml ). One of the species had cellular bone and the other two had acellular bone. Results revealed that δ15 N and δ13 C values from different skeletal elements were interchangeable in species with acellular bone, but caution was needed in species with cellular bone, as δ15 N values varied among skeletal elements. Furthermore, δ15 Nbulk values were significantly lower than δ15 Ndml values in the three species, thus suggesting that they are not comparable. This difference is probably because δ15 Nbulk refers to total bone protein and δ15 Ndml to collagen only.
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Affiliation(s)
- M Bas
- Centro Austral de Investigaciones Científicas (CADIC-CONICET), C/Bernardo Houssay 200, 9410, Ushuaia, Argentina
- Biodiversity Research Institute (IRBio), University of Barcelona, Av. Diagonal 643, 08028, Barcelona, Spain
| | - L Cardona
- Biodiversity Research Institute (IRBio), University of Barcelona, Av. Diagonal 643, 08028, Barcelona, Spain
- Department of Evolutionary Biology, Ecology and Environmental Science, University of Barcelona, Av. Diagonal 643, 08028, Barcelona, Spain
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4
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Abstract
Objectives: Analysis of pre-operative tracheostomy and circumjacent tumour free margins as risk factors in the development of stomal recurrent disease after (pharyngo)laryngectomy. Material and Methods: 124 patients after (pharyngo)laryngectomy were analyzed for disease related data and tumour samples were analyzed for tumour free margins. The overall cohort was divided into patients with/withour pre-operative tracheostomy. Results: 18 patients suffered from recurrent disease (10 stomal, 8 distant metastases). Advanced T-status, female gender, and sub-/glottic tumour manifestation resulted in a higher rate of prior tracheostomy. Pre-operative tracheostomy did not influence the development of stomal recurrency. R0 resection was achieved in 94% of our patients, with significant reduced tumour free margins in patients with stomal recurrency (p=0.002) Conclusion: Pre-operative tracheostomy did not influence the development of stomal recurrent disease. The clinical identification of ventral soft tissue infiltration should result in extensive surgical concepts.
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Affiliation(s)
- S Teutsch
- Hals-Nasen-Ohrenklinik und Poliklinik, Technische Universität München, München
| | - M Bas
- Hals-Nasen-Ohrenklinik und Poliklinik, Technische Universität München, München
| | - H Bier
- Hals-Nasen-Ohrenklinik und Poliklinik, Technische Universität München, München
| | - A Knopf
- Hals-Nasen-Ohrenklinik und Poliklinik, Technische Universität München, München
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5
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Hahn J, Bas M, Hoffmann TK, Greve J. [Bradykinin-induced angioedema: Definition, pathogenesis, clinical presentation, diagnosis and therapy]. HNO 2016; 63:885-93; quiz 894-5. [PMID: 26597136 DOI: 10.1007/s00106-015-0084-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 12/11/2022]
Abstract
The incidence of bradykinin-induced angioedema is considerably lower than that of histamine-induced forms; however, the same is true for the clinician's knowledge of this condition. Bradykinin-induced angioedemas include hereditary angioedema (HAE), as well as acquired forms induced by drugs or antibody formation, e.g., during the course of oncologic disease. Drug-induced forms affect almost exclusively the head and neck region, and are thus important for the otorhinolaryngologist. Clear differentiation between histamine-induced angioedema (e. g., connected to allergy/urticaria) and bradykinin-induced angioedema is essential for selection of the specific treatment and may be lifesaving. Antihistamines and cortisone derivatives have no relevant effect in bradykinin induced-angioedema, whereas blood-derived C1 esterase inhibitor and bradykinin receptor 2 antagonists represent effective therapeutic options--both for acute and prophylactic treatment.
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Affiliation(s)
- J Hahn
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89070, Ulm, Deutschland.
| | - M Bas
- Hals-Nasen-Ohren-Klinik und Poliklinik, Technische Universität München, München, Deutschland
| | - T K Hoffmann
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89070, Ulm, Deutschland
| | - J Greve
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89070, Ulm, Deutschland
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Hofauer B, Bas M, Mansour N, Loeffelbein D, Knopf A. SAT0289 Sonographic Alterations during The Course of Sjögren's Syndrome – A Five-Year Follow Up. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5284] [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: 11/03/2022]
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7
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Gilles-Stein S, Beck I, Chaker A, Bas M, McIntyre M, Cifuentes L, Petersen A, Gutermuth J, Schmidt-Weber C, Behrendt H, Traidl-Hoffmann C. Pollen derived low molecular compounds enhance the human allergen specific immune response in vivo. Clin Exp Allergy 2016; 46:1355-65. [PMID: 27061126 DOI: 10.1111/cea.12739] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 02/25/2016] [Accepted: 03/19/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND Besides allergens, pollen release bioactive, low molecular weight compounds that modulate and stimulate allergic reactions. Clinical relevance of these substances has not been investigated to date. OBJECTIVE To elucidate the effect of a non-allergenic, low molecular weight factors from aqueous birch pollen extracts (Bet-APE < 3 kDa) on the human allergic immune response in vivo. METHODS Birch and grass pollen allergic individuals underwent skin prick testing with allergen alone, allergen plus Bet-APE < 3 kDa, or allergen plus pre-identified candidate substances from low molecular pollen fraction. Nasal allergen challenges were performed in non-atopic and pollen allergic individuals using a 3 day repeated threshold challenge battery. Subjects were either exposed to allergen alone or to allergen plus Bet-APE< 3 kDa. Local cytokine levels, nasal secretion weights, nasal congestion and symptom scores were determined. RESULTS Skin prick test reactions to pollen elicited larger weals when allergens were tested together with the low molecular weight compounds from pollen. Similar results were obtained with candidate pollen-associated lipid mediators. In nasal lining fluids of allergic patients challenged with allergen plus Bet-APE < 3 kDa, IL-8 and IgE was significantly increased as compared to allergen-only challenged patients. These patients also produced increased amounts of total nasal secretion and reported more severe rhinorrhea than the allergen-only challenged group. CONCLUSIONS Low molecular compounds from pollen enhance the allergen specific immune response in the skin and nose. They are therefore of potential clinical relevance in allergic patients.
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Affiliation(s)
- S Gilles-Stein
- Chair and Institute of Environmental Medicine, UNIKA-T, Technical University Munich and Helmholtz Center Munich, Augsburg, Germany. .,ZAUM - Center of Allergy & Environment, Technical University Munich and Helmholtz Center Munich, Munich, Germany. .,Christine-Kühne-Center for Allergy Research and Education (CK Care), Davos, Switzerland.
| | - I Beck
- Chair and Institute of Environmental Medicine, UNIKA-T, Technical University Munich and Helmholtz Center Munich, Augsburg, Germany.,ZAUM - Center of Allergy & Environment, Technical University Munich and Helmholtz Center Munich, Munich, Germany
| | - A Chaker
- ZAUM - Center of Allergy & Environment, Technical University Munich and Helmholtz Center Munich, Munich, Germany.,ENT Department, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
| | - M Bas
- ENT Department, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
| | - M McIntyre
- Department of Dermatology and Allergy, Technische Universität München, Munich, Germany
| | - L Cifuentes
- Department of Dermatology and Allergy, Technische Universität München, Munich, Germany.,Molecular Immunology, Department of Allergy and Clinical Immunology, National Heart and Lung Institute, Imperial College, London, UK
| | - A Petersen
- Division of Clinical and Molecular Allergology, Research Center Borstel, Airway Research Center North (ARCN), Borstel, Germany
| | - J Gutermuth
- ZAUM - Center of Allergy & Environment, Technical University Munich and Helmholtz Center Munich, Munich, Germany.,Department of Dermatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - C Schmidt-Weber
- ZAUM - Center of Allergy & Environment, Technical University Munich and Helmholtz Center Munich, Munich, Germany
| | - H Behrendt
- ZAUM - Center of Allergy & Environment, Technical University Munich and Helmholtz Center Munich, Munich, Germany
| | - C Traidl-Hoffmann
- Chair and Institute of Environmental Medicine, UNIKA-T, Technical University Munich and Helmholtz Center Munich, Augsburg, Germany.,ZAUM - Center of Allergy & Environment, Technical University Munich and Helmholtz Center Munich, Munich, Germany.,Christine-Kühne-Center for Allergy Research and Education (CK Care), Davos, Switzerland
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8
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Bas M. [Strong and Deficient Evidence in Drug-Treated, Non-Tumorous Diseases in ENT]. Laryngorhinootologie 2016; 95 Suppl 1:S217-32. [PMID: 27128402 DOI: 10.1055/s-0041-108940] [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: 10/21/2022]
Abstract
While many high quality studies are available for the specific immunotherapy of the allergic rhinitis and limited for the angiotensin-converting enzyme inhibitor induced angioedema available, the evidence is very low for Ménière's disease or for the medicinal treatment of post-surgery laryngeal edema. This paper discusses the study data and evidence of the respective diseases.
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Bas M, Greve J, Strassen U, Khosravani F, Hoffmann TK, Kojda G. Angioedema induced by cardiovascular drugs: new players join old friends. Allergy 2015; 70:1196-200. [PMID: 26119220 DOI: 10.1111/all.12680] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [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: 06/19/2015] [Indexed: 12/11/2022]
Abstract
During the last years, two new cardiovascular drug classes, namely inhibitors of DPP IV or neprilysin, have been developed. In both cases, there is clinical evidence for their potential to induce angioedema as known already from blockers of the renin-angiotensin-aldosterone system (RAAS). The majority of angioedema induced by DPP IV inhibitors occurs during concomitant treatment with ACEi and is therefore likely mediated by overactivation of bradykinin type 2 receptors (B2). In striking contrast, the molecular pathways causing angioedema induced by neprilysin inhibitors, that is, sacubitril, are unclear, although a contribution of bradykinin appears likely. Nevertheless, there is no clinical evidence suggesting that inhibition of B2 might relieve the symptoms and/or prevent invasive treatment including coniotomy or tracheotomy in angioedema caused by these drugs. Therefore, the risk of angioedema should always be considered, especially in ambulatory care situations where patients have no rapid access to intensive care.
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Affiliation(s)
- M. Bas
- Otorhinolaryngology Department; University Hospital Rechts der Isar; Munich Technical University; Munich Germany
| | - J. Greve
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery; Ulm University Medical Center; Ulm Germany
| | - U. Strassen
- Otorhinolaryngology Department; University Hospital Rechts der Isar; Munich Technical University; Munich Germany
| | - F. Khosravani
- Institute of Pharmacology and Clinical Pharmacology; Heinrich Heine University; Düsseldorf Germany
| | - T. K. Hoffmann
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery; Ulm University Medical Center; Ulm Germany
| | - G. Kojda
- Institute of Pharmacology and Clinical Pharmacology; Heinrich Heine University; Düsseldorf Germany
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Khosravani F, Suvorava T, Dao VTV, Brockmann N, Kocgirli O, Herbst FF, Valcaccia S, Kassack MU, Bas M, Kojda G. Stability of murine bradykinin type 2 receptor despite treatment with NO, bradykinin, icatibant, or C1-INH. Allergy 2015; 70:285-94. [PMID: 25477154 DOI: 10.1111/all.12556] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 12/02/2014] [Indexed: 01/16/2023]
Abstract
BACKGROUND Little is known about factors which trigger and/or contribute to hereditary angioedema or ACE-inhibitor-mediated angioedema including variations in bradykinin type 2 receptor (B2R) expression and activity. METHODS Protein and mRNA expression of B2R and the increase of intracellular calcium (iCa) in response to bradykinin were monitored in porcine and murine endothelial cells in response to NO donors or bradykinin. B2R protein expression was evaluated in skin, heart, and lung of (i) mice with endothelial-specific overexpression of eNOS (eNOS(tg) ), (ii) in eNOS(-/-) mice and (iii) in C57BL/6 mice treated with the NO donor pentaerythritol tetranitrate (PETN), the NOS inhibitor l-nitroarginine (L-NA), plasma pool C1-INH, and the B2R antagonist icatibant. Aortic reactivity to bradykinin was investigated including eNOS(-/-) mice. RESULTS B2R protein and mRNA expression remained unchanged in cells subjected to L-NA, NO donors, and bradykinin in a time- and concentration-dependent manner. Likewise, increases of iCa in murine brain endothelial cells remained unchanged. B2R protein levels were similar in eNOS(tg) and eNOS(-/-) as compared to transgene-negative littermates. Likewise, treatment of C57BL/6 mice with PETN, L-NA, C1-INH or icatibant did not change B2R protein expression. In aortic rings of C57BL/6 mice, bradykinin induced B2R-dependent constrictions which were attenuated by endothelial NO and abolished by diclofenac indicating the functional importance of B2R-induced activation of endothelial NO synthase and cyclooxygenase. CONCLUSION These data suggest that alterations of B2R protein expression induced by NO, bradykinin, C1-INH, or icatibant unlikely contribute to bradykinin-induced angioedema. This finding does not rule out a role for NO in bradykinin-induced extravasation and/or angioedema.
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Affiliation(s)
- F. Khosravani
- Institute of Pharmacology and Clinical Pharmacology; Heinrich-Heine-University; Düsseldorf Germany
| | - T. Suvorava
- Institute of Pharmacology and Clinical Pharmacology; Heinrich-Heine-University; Düsseldorf Germany
| | - V. T.-V. Dao
- Institute of Pharmacology and Clinical Pharmacology; Heinrich-Heine-University; Düsseldorf Germany
| | - N. Brockmann
- Institute of Pharmaceutical and Medicinal Chemistry; Heinrich-Heine-University; Düsseldorf Germany
| | - O. Kocgirli
- Institute of Pharmacology and Clinical Pharmacology; Heinrich-Heine-University; Düsseldorf Germany
| | - F. F. Herbst
- Institute of Pharmacology and Clinical Pharmacology; Heinrich-Heine-University; Düsseldorf Germany
| | - S. Valcaccia
- Institute of Pharmacology and Clinical Pharmacology; Heinrich-Heine-University; Düsseldorf Germany
| | - M. U. Kassack
- Institute of Pharmaceutical and Medicinal Chemistry; Heinrich-Heine-University; Düsseldorf Germany
| | - M. Bas
- Otorhinolaryngology Department; University Hospital Rechts der Isar; Munich Technical University; Munich Germany
| | - G. Kojda
- Institute of Pharmacology and Clinical Pharmacology; Heinrich-Heine-University; Düsseldorf Germany
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Greve J, Schuler PJ, Mandapathil M, Dominas N, Veit J, Bas M, Lehnerdt G, Hoffmann TK. [Penetrating injuries of the head and neck region - a potentially life threatening situation]. Laryngorhinootologie 2014; 93:671-6. [PMID: 24978127 DOI: 10.1055/s-0034-1376974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
UNLABELLED Penetrating Injuries of the Head and Neck Region - A Potentially Life Threatening Situation Background: Cuts, stabs and gunshot wounds in the head and neck region are potentially life-threatening because of the high risk of vascular lesions. A consistent emergency management is usually based on an operative exploration of the wound with effective reconstruction of viable structures. PATIENTS AND METHODS Various penetrating injuries of the head and neck region are described in 11 cases with respect of age, gender, course of events of injury, type of injury, involved structures, diagnostic and operative procedures and outcome and compared with current literature and guidelines. RESULTS In 10 of 11 patients, in the context of an interdisciplinary emergency room management, CT angiography was performed following clinical examination. A surgical exploration and wound treatment was performed in 9 of these patients. The common carotid artery, the external carotid artery and large venous blood vessels of the neck were injured in 2 cases respectively. None of the patients deceased or suffered permanent damage. CONCLUSION The outcome of deep head and neck lesions with relevant vascular trauma is determined by a rapid and interdisciplinary approach. A rapid, systematic and interdisciplinary approach in specialized trauma centers has a significant role in ensuring that patients with penetrating wounds in the head and neck -region rarely die due to their serious injury or their consequences.
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Affiliation(s)
- J Greve
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Ulm, Ulm
| | - P J Schuler
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Ulm, Ulm
| | - M Mandapathil
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Giessen und Marburg, Standort Marburg, Marburg
| | - N Dominas
- Hals-, Nasen-, Ohrenklinik, Universitätsklinik Essen, Essen
| | - J Veit
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Ulm, Ulm
| | - M Bas
- Hals-Nasen-Ohren-Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, München
| | - G Lehnerdt
- Hals-, Nasen-, Ohrenklinik, Universitätsklinik Essen, Essen
| | - T K Hoffmann
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Ulm, Ulm
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Knopf A, Drecoll E, Becker K, Bas M, Mansour N, Hofauer B. AB0504 Salivary Interleukin 6 in Primary Sjoegren's Syndrome Mo. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5877] [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: 11/04/2022]
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13
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Hofauer B, Bas M, Mansour N, Knopf A. THU0002 Pathological Findings Using High END Ultrasonography in Primary SjÖGren's Syndrome. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5901] [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: 11/03/2022]
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14
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Cicardi M, Aberer W, Banerji A, Bas M, Bernstein JA, Bork K, Caballero T, Farkas H, Grumach A, Kaplan AP, Riedl MA, Triggiani M, Zanichelli A, Zuraw B. Classification, diagnosis, and approach to treatment for angioedema: consensus report from the Hereditary Angioedema International Working Group. Allergy 2014; 69:602-16. [PMID: 24673465 DOI: 10.1111/all.12380] [Citation(s) in RCA: 408] [Impact Index Per Article: 40.8] [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: 01/21/2014] [Indexed: 01/13/2023]
Abstract
Angioedema is defined as localized and self-limiting edema of the subcutaneous and submucosal tissue, due to a temporary increase in vascular permeability caused by the release of vasoactive mediator(s). When angioedema recurs without significant wheals, the patient should be diagnosed to have angioedema as a distinct disease. In the absence of accepted classification, different types of angioedema are not uniquely identified. For this reason, the European Academy of Allergy and Clinical Immunology gave its patronage to a consensus conference aimed at classifying angioedema. Four types of acquired and three types of hereditary angioedema were identified as separate forms from the analysis of the literature and were presented in detail at the meeting. Here, we summarize the analysis of the data and the resulting classification of angioedema.
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Affiliation(s)
- M. Cicardi
- Department of Biomedical and Clinical Sciences Luigi Sacco; University of Milan; Luigi Sacco Hospital Milan; Milan Italy
| | - W. Aberer
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - A. Banerji
- Division of Rheumatology, Allergy and Immunology; Massachusetts General Hospital; Boston MA USA
| | - M. Bas
- Department of Otorhinolaryngology; Klinikum rechts der Isar; Technische Universität München; Munich Germany
| | - J. A. Bernstein
- Division of Immunology/Allergy Section; Department of Internal Medicine; University of Cincinnati College of Medicine; Cincinnati OH USA
| | - K. Bork
- Department of Dermatology; Johannes Gutenberg University; Mainz Germany
| | - T. Caballero
- Department of Allergy; Hospital La Paz Institute for Health Research (IdiPaz); Biomedical Research Network on Rare Diseases-U754 (CIBERER); Madrid Spain
| | - H. Farkas
- 3rd Department of Internal Medicine; National Angioedema Center; Semmelweis University; Budapest Hungary
| | - A. Grumach
- Department of Clinical Medicine; Faculty of Medicine ABC; Sao Paulo Brazil
| | - A. P. Kaplan
- Medical University of South Carolina; Charleston SC
| | - M. A. Riedl
- Division of Rheumatology, Allergy and Immunology; Department of Medicine; University of California - San Diego; La Jolla CA USA
| | - M. Triggiani
- Department of Medicine; University of Salerno; Salerno Italy
| | - A. Zanichelli
- Department of Biomedical and Clinical Sciences Luigi Sacco; University of Milan; Luigi Sacco Hospital Milan; Milan Italy
| | - B. Zuraw
- Division of Rheumatology, Allergy and Immunology; Department of Medicine; University of California - San Diego; La Jolla CA USA
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Hofauer B, Bas M, Strassen U, Matsuba Y, Mansour N, Knopf A. [Liposomal local therapy of sinunasal symptoms in ANCA associated vasculitis]. Laryngorhinootologie 2014; 93:461-6. [PMID: 24777579 DOI: 10.1055/s-0034-1372588] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND GPA, eGPA and MPA constitute the group of AAV. ENT manifestations are part of the typical clinical picture of these diseases. Usually, patients are treated with systemic immunomodulatory drugs, mostly based on organ affection. In clinical routine, an insufficient decrease of sinunasal manifestations during a solely systemic therapeutic concept can repeatedly be -observed. MATERIAL AND METHODS Between February 2009 and November 2012, 20 patients with AAV were diagnosed in or referred to our department for further treatment. Clinical symptoms and manifestations were measured by the use of international accepted activity scores. The effect of a local therapy with liposomes for a period of 2 months on sinunasal symptoms was prospectively evaluated by using visual analogue scales and standardized questionnaires. RESULTS Within the described collective 100% of patients did show ENT-symptoms at the time of initial diagnosis. Every patient did receive immunomodulatory therapy, but in 61.1% of cases there was just slight or no improvement on sinunasal symptoms. After a 2-month period of liposomal local therapy, a significant reduction of sinunasal complaints could be observed, both evaluated via visual analogue scales (p<0.001 to p=0.014, depending on the evaluated symptom) and standardized questionnaires (p<0.001). CONCLUSIONS The local application of liposomes in addition to a systemic therapy is effective in alleviating sinunasal manifestations in patients with AAV.
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Affiliation(s)
- B Hofauer
- Klinikum rechts der Isar, Hals-Nasen-Ohrenklinik und Poliklinik, München
| | - M Bas
- Klinikum rechts der Isar, Hals-Nasen-Ohrenklinik und Poliklinik, München
| | - U Strassen
- Klinikum rechts der Isar, Hals-Nasen-Ohrenklinik und Poliklinik, München
| | - Y Matsuba
- Klinikum rechts der Isar, Hals-Nasen-Ohrenklinik und Poliklinik, München
| | - N Mansour
- Klinikum rechts der Isar, Hals-Nasen-Ohrenklinik und Poliklinik, München
| | - A Knopf
- Klinikum rechts der Isar, Hals-Nasen-Ohrenklinik und Poliklinik, München
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Storck K, Bas M, Gurr A, Staudenmaier R, Stark T. [Complications in 312 cases of nasal and auricular reconstruction via autologous rib cartilage]. Laryngorhinootologie 2013; 92:808-14. [PMID: 23945713 DOI: 10.1055/s-0033-1351261] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND We present the results and complications with autologous rib cartilage in comparison to other materials in nasal and auricular reconstruction using a large patient collective from our clinic. MATERIAL AND METHODS The retrospective study included all cases of auricular and nasal reconstruction via rib cartilage between 2001 and 2009. The outcome was analysed by subjective and objective parameters. RESULTS 51/321 patients underwent plastic reconstructive surgery of the nose, 270/321 received a partial or complete auricle reconstruction with autologous rib cartilage. The complication rate e.g. of hematomas, lesions of the pleura, postoperative pain and keloids at the donation site was small. Concerning the aesthetic results of the nose and auricles 273 of 321 (85%) were satisfied after the first operation. Only 3/51 nasal reconstructions underwent a second operation. In case of complete auricular reconstructions, all patients underwent at least 2 operations for the three-dimensional look. CONCLUSIONS The use of autologous rip cartilage is still a good option in the auricular and nasal reconstruction. Depending on the expertise of the surgeon the postoperative aesthetic results are good with a low complication rate. However concerning the bigger effort in several aspects for the surgeon as the patient it should be reserved to specific indication criterias.
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Affiliation(s)
- K Storck
- Klinikum rechts der Isar, Hals-, Nasen-, Ohrenheilkunde, München
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Khosravani F, Suvorava T, Brockmann N, Dao VT, Bisha M, Kassack M, Bas M, Kojda G. Effects of NO on the expression and function of bradykinin type 2 receptors. Role for angioedema? Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p4173] [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
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Hofauer B, Bas M, Mansour N, Knopf A. THU0269 Liposomal Local Therapy as Treatment of Sicca Symptoms in Patients with Primary SjöGren´s Syndrome. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.797] [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: 11/03/2022]
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20
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Hoffmann TK, Arnolds J, Schuler PJ, Kultas E, Greve J, Mansour N, Bas M, Lang S, Hilpert A. [Secondary wound healing. Effective treatment concept after basal cell carcinoma resection in the central midface]. HNO 2012; 60:605-10. [PMID: 22763766 DOI: 10.1007/s00106-011-2473-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Plastic reconstruction of facial skin defects after tumor surgery is a commonly accepted principle. However, healing by secondary intention is discussed controversially. Here we describe a series of 22 patients after full thickness resection of basal cell carcinoma who underwent wound healing by secondary intention. A semipermeable membrane was used for wound dressing, which was changed on a weekly basis. No antibiotics or pain killers were necessary. Defects up to 2 cm, particularly those of concave subunits of the midface, entirely closed within 4-6 weeks, and secondary wound healing led to excellent functional and aesthetic results. Thus, secondary wound healing is a safe, effective and economic alternative to surgical reconstruction in selected facial areas.
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Affiliation(s)
- T K Hoffmann
- HNO-Universitätsklinik, Universität Essen, Hufelandstrasse 55, Essen, Germany.
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Mansour N, Stock KF, Chaker A, Bas M, Knopf A. Evaluation of parotid gland lesions with standard ultrasound, color duplex sonography, sonoelastography, and acoustic radiation force impulse imaging - a pilot study. Ultraschall Med 2012; 33:283-288. [PMID: 22504938 DOI: 10.1055/s-0031-1299130] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE To evaluate the impact of standard ultrasound (US), color duplex sonography (CDS), sonoelastography (SE), and acoustic radiation force impulse (ARFI) imaging in the differentiation of parotid gland lesions. MATERIALS AND METHODS From September 2010 to February 2011, 33 parotid gland lesions of 32 patients were included in this study. Patients underwent high-resolution B-mode US (THI, 9 - 14 MHz), CDS, SE, and ARFI quantification. Then parotidectomy was performed and samples were analyzed by (immuno-) histology. Data was extracted via unpaired t-test and expressed in p-values. RESULTS There were 12 Wathin's tumors (WT), 11 pleomorphic adenomas (PA), 3 other benign tumors, 3 ductal dilatations, 2 neuroendocrine carcinomas, 1 non-Hodgkin lymphoma, and 1 malignant melanoma metastasis. In B-mode US, acoustic enhancement showed statistical significance between PA and WT (p < 0.005), and CDS determined different vascularization patterns (p < 0.0005). While SE did not visualize any significant difference between PA and WT, ARFI quantification determined different mean values for both entities (p < 0.003). CONCLUSION B-mode US, CDS, and ARFI quantification distinguish PA from WT. The predictive value of the modern techniques for the differentiation of benign and malignant parotid lesions has to be assessed in a larger series.
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MESH Headings
- Adenolymphoma/diagnostic imaging
- Adenolymphoma/pathology
- Adenolymphoma/surgery
- Adenoma, Pleomorphic/diagnostic imaging
- Adenoma, Pleomorphic/pathology
- Adenoma, Pleomorphic/surgery
- Carcinoma, Neuroendocrine/diagnostic imaging
- Carcinoma, Neuroendocrine/pathology
- Carcinoma, Neuroendocrine/surgery
- Dilatation, Pathologic/diagnostic imaging
- Dilatation, Pathologic/pathology
- Elasticity Imaging Techniques/methods
- Humans
- Lymphoma, Non-Hodgkin/diagnostic imaging
- Lymphoma, Non-Hodgkin/pathology
- Lymphoma, Non-Hodgkin/surgery
- Melanoma/diagnostic imaging
- Melanoma/pathology
- Melanoma/secondary
- Melanoma/surgery
- Parotid Diseases/diagnostic imaging
- Parotid Diseases/pathology
- Parotid Diseases/surgery
- Parotid Gland/diagnostic imaging
- Parotid Gland/pathology
- Parotid Gland/surgery
- Parotid Neoplasms/diagnostic imaging
- Parotid Neoplasms/pathology
- Parotid Neoplasms/secondary
- Parotid Neoplasms/surgery
- Pilot Projects
- Salivary Ducts/diagnostic imaging
- Salivary Ducts/pathology
- Sensitivity and Specificity
- Skin Neoplasms/diagnostic imaging
- Skin Neoplasms/pathology
- Skin Neoplasms/surgery
- Ultrasonography, Doppler, Color/methods
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Affiliation(s)
- N Mansour
- HNO-Klinik, Klinikum rechts der Isar der Technischen Universität München.
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Maurer M, Bader M, Bas M, Bossi F, Cicardi M, Cugno M, Howarth P, Kaplan A, Kojda G, Leeb-Lundberg F, Lötvall J, Magerl M. New topics in bradykinin research. Allergy 2011; 66:1397-406. [PMID: 21859431 DOI: 10.1111/j.1398-9995.2011.02686.x] [Citation(s) in RCA: 121] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Bradykinin has been implicated to contribute to allergic inflammation and the pathogenesis of allergic conditions. It binds to endothelial B(1) and B(2) receptors and exerts potent pharmacological and physiological effects, notably, decreased blood pressure, increased vascular permeability and the promotion of classical symptoms of inflammation such as vasodilation, hyperthermia, oedema and pain. Towards potential clinical benefit, bradykinin has also been shown to exert potent antithrombogenic, antiproliferative and antifibrogenic effects. The development of pharmacologically active substances, such as bradykinin receptor blockers, opens up new therapeutic options that require further research into bradykinin. This review presents current understanding surrounding the role of bradykinin in nonallergic angioedema and other conditions seen by allergists and emergency physicians, and its potential role as a therapeutic target.
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Affiliation(s)
- M Maurer
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité- Universitätsmedizin, Berlin, Germany.
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Zimmermann A, Cohnen M, Mansour N, Bas M, Kübler N, Hoffmann T. Craniocervical necrotizing fasciitis: Radiologic findings in comparison to deep neck abscess. Int J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.ijom.2011.07.117] [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: 11/28/2022]
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Knopf A, Bas M, Chaker A, Strassen U, Pickhard A, Stark T, Lahmer T, Thurmel K. Rheumatic disorders affecting the head and neck: underestimated diseases. Rheumatology (Oxford) 2011; 50:2029-34. [DOI: 10.1093/rheumatology/ker213] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Schuler PJ, Börger V, Bölke E, Habermehl D, Matuschek C, Wild CA, Greve J, Bas M, Schilling B, Bergmann C, Trellakis S, Budach W, Gauler T, Brandau S, Lang S, Whiteside TL, Sorg RV, Hoffmann TK. Dendritic cell generation and CD4+ CD25high FOXP3+ regulatory t cells in human head and neck carcinoma during radio-chemotherapy. Eur J Med Res 2011; 16:57-62. [PMID: 21463982 PMCID: PMC3353422 DOI: 10.1186/2047-783x-16-2-57] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [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] [Indexed: 11/28/2022] Open
Abstract
Background Regulatory T cells (Treg) and dendritic cells (DC) play an important role in tumor immunity and immune escape. However, their interplay and the effects of anti-cancer therapy on the human immune system are largely unknown. Methods For DC generation, CD14+ monocytes were enriched by immunomagnetic selection from peripheral blood of advanced head and neck squamous cell carcinoma (HNSCC) patients and differentiated into immature DC using GM-SCF and IL-4. DC maturation was induced by addition of TNFα. The frequency of CD4+CD25highF0XP3+ Treg in HNSCC patients was analyzed before and after radio-chemotherapy (RCT) by four-color flow cytometry. Results In HNSCC patients, the frequency of Treg (0.33 ± 0.06%) was significantly (p = 0.001) increased compared to healthy controls (0.11 ± 0.02%), whereas RCT had variable effects on the Treg frequency inducing its increase in some patients and decrease in others. After six days in culture, monocytes of all patients had differentiated into immature DC. However, DC maturation indicated by CD83 up-regulation (70.7 ± 5.5%) was successful only in a subgroup of patients and correlated well with lower frequencies of peripheral blood Treg in those patients. Conclusion The frequency of regulatory T cells is elevated in HNSCC patients and may be modulated by RCT. Monocyte-derived DC in HNSCC patients show a maturation deficiency ex vivo. Those preliminary data may have an impact on multimodality clinical trials integrating cellular immune modulation in patients with advanced HNSCC.
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Affiliation(s)
- Patrick J Schuler
- Department of Otorhinolaryngology, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany.
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Pfaar O, Glowania A, Umbreit C, Sahin G, Klimek L, Koop N, Isselstein J, Maune S, Förster U, Strathmann S, Olze H, Kirsche H, Iro H, Mayr S, Weiß D, Sachse F, Rudack C, Bas M, Schäfer D, Maier H, Baenkler H, Mühlmeier G, Basel T, Bachert C, Tomassen P, Cardell L, Fokkens W, Kowalski M, Hellings P, Mullol J, Tskala E. HNO-Symposium der DGHNOKHC. Allergo J 2011. [DOI: 10.1007/bf03362410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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27
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Schuler PJ, Trellakis S, Greve J, Bas M, Bergmann C, Bölke E, Lehnerdt G, Mattheis S, Albers AE, Brandau S, Lang S, Whiteside TL, Bier H, Hoffmann TK. In vitro chemosensitivity of head and neck cancer cell lines. Eur J Med Res 2010; 15:337-44. [PMID: 20947470 PMCID: PMC3458702 DOI: 10.1186/2047-783x-15-8-337] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [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] [Indexed: 01/21/2023] Open
Abstract
Background Systemic treatment of head and neck squamous cell carcinoma (HNSCC) includes a variety of antineoplastic drugs. However, drug-resistance interferes with the effectiveness of chemotherapy. Preclinical testing models are needed in order to develop approaches to overcome chemoresistance. Methods Ten human cell lines were obtained from HNSCC, including one with experimentally-induced cisplatin resistance. Inhibition of cell growth by seven chemotherapeutic agents (cisplatin, carboplatin, 5- fluorouracil, methotrexate, bleomycin, vincristin, and paclitaxel) was measured using metabolic MTT-uptake assay and correlated to clinically-achievable plasma concentrations. Results All drugs inhibited cell growth in a concentration-dependent manner with an IC50 comparable to that achievable in vivo. However, response curves for methotrexate were unsatisfactory and for paclitaxel, the solubilizer cremophor EL was toxic. Cross-resistance was observed between cisplatin and carboplatin. Conclusion Chemosensitivity of HNSCC cell lines can be determined using the MTT-uptake assay. For DNA-interfering cytostatics and vinca alkaloids this is a simple and reproducible procedure. Determined in vitro chemosensitivity serves as a baseline for further experimental approaches aiming to modulate chemoresistance in HNSCC with potential clinical significance.
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Affiliation(s)
- P J Schuler
- Hals-Nasen-Ohrenklinik, Universität Duisburg-Essen, 45147 Essen, Germany.
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Bas M, Kojda G, Stelter K. [Angiotensin-converting enzyme inhibitor induced angioedema : new therapy options]. Anaesthesist 2010; 60:1141-5. [PMID: 20922352 DOI: 10.1007/s00101-010-1798-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2010] [Revised: 08/29/2010] [Accepted: 09/01/2010] [Indexed: 01/13/2023]
Abstract
Angiotensin-converting enzyme (ACE) inhibitors block the catalysis of angiotensin I to angiotensin II and also the breakdown of bradykinin. ACE inhibitor-induced angioedema is mediated by inhibited bradykinin degradation leading to enhanced bradykinin plasma levels. The efficacy of currently used standard treatments with antiallergic drugs is questionable. A patient with acute ACE inhibitor-induced angioedema was treated with icatibant, a specific bradykinin B2 receptor antagonist approved for the treatment of hereditary angioedema. A single subcutaneous injection of 30 mg icatibant resulted in a rapid onset of symptom relief and a remarkable shortening of duration of the attack.
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Affiliation(s)
- M Bas
- Hals-Nasen-Ohrenklinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Deutschland.
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Greve J, Schuler PJ, Bas M, Adamzik M, Brandau S, Arweiler-Harbeck D, Lang S, Hoffmann TK. [Coagulation factors as potential tumour markers in patients with head and neck carcinomas?]. Laryngorhinootologie 2010; 89:612-5. [PMID: 20628968 DOI: 10.1055/s-0030-1261892] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Carcinomas can have influence on the coagulation system by different factors. Locally pathological changes of metabolism, neo-vascularisation, oxygenation and tissue pressure as well as locally and systemically activities of the tumor cells, are part of it. The coagulation situation in patients with head and neck carcinomata is characterized only insufficiently till now. MATERIAL AND METHODS In a prospective pilot study 20 male patients with squamous-cell carcinomas of the head and neck area were subjected to a detailed coagulation diagnostics pre and post therapeutically and, age and sex corrected, compared with a control group (n=37). RESULTS For the routine parameters PTT, Quick, TZ and INR no differences between the groups could be recognized. For the tumour patients a statistically significant increase arose for the acute phase proteins like factor I (fibrinogen), factor VIII, factor IX, von- Willebrand antigen and activity before therapy. Increased values were found also for plasmin, factor II, factor V and the thrombin-antithrombin-III-complex (TAT) whereas the values for antithrombin-III were degraded significantly. In the tumour patients the pre-therapeutical increased values for the activation marker TAT brought themselves back to normal after the tumour ablative therapy. CONCLUSIONS TAT could be suitable as a potential tumour marker but also for relapse tumours. To evidence this, a study of longer duration and with a larger number of patients is necessary.
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Affiliation(s)
- J Greve
- Universitätsklinikum Essen, Hals-, Nasen-, Ohrenklinik, Essen, Germany.
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Abstract
Basaloid squamous cell carcinoma (BSCC) is a rare tumor representing an aggressive variant of squamous cell carcinoma (SCC) and arising from a common precursor cell. BSCC rarely originates from the sinonasal tract. We report on an 83-year-old woman with BSCC after multiple resections of an inverted papilloma (IP) of the left sinonasal tract. The tumor filled the nasal cavity completely and was infiltrating the ipsilateral frontal skull base and periorbita. Because of the tumor's expansion, the patient's age, and comorbidity, surgery was not performed, but primary radiotherapy was initiated. A possible association between sinonasal BSCC and IP, as implicated by the current case, must be further investigated. In any case, IP requires consequent endoscopic and, if necessary, radiological follow-up in order to detect recurrent disease or malignant transformation.
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Affiliation(s)
- A Knopf
- Hals-, Nasen- und Ohrenklinik , Klinikum rechts der Isar, Technische Universität, München
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Greve J, Bas M, Schipper J, Hoffmann T. Primäre kutane Manifestation eines Vorläufer-B-lymphoblastischen Lymphoms im Bereich des äußeren Ohres. Laryngorhinootologie 2008; 87:728-30. [DOI: 10.1055/s-2007-995788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Oppermann M, Dao VTV, Suvorava T, Bas M, Kojda G. Effect of oral organic nitrates on expression and activity of vascular soluble guanylyl cyclase. Br J Pharmacol 2008; 155:335-42. [PMID: 18587420 DOI: 10.1038/bjp.2008.269] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND AND PURPOSE The regulation of vascular soluble guanylyl cyclase (sGC) expression by nitric oxide (NO) is still under discussion. In vitro, NO has been shown to downregulate the expression of sGC but it is unclear if this mechanism is operative in vivo and occurs during nitrate treatment. EXPERIMENTAL APPROACH We investigated whether high dose isosorbide mononitrate (ISMN) or pentaerythrityl tetranitrate (PETN) treatment changes vascular sGC expression and activity in vivo. New Zealand White rabbits received a standard diet, 2 or 200 mg ISMN kg(-1) d(-1) for 16 weeks, and C57BL/6 mice received a standard diet, 6, 60 or 300 mg PETN kg(-1) d(-1) for four weeks. Absorption was checked by measuring the plasma levels of the drug/metabolite. KEY RESULTS Western blots of rabbit aortic rings showed similar protein levels of sGC alpha1- (P=0.2790) and beta1-subunits (P=0.6900) in all groups. Likewise, ANOVA showed that there was no difference in the expression of sGC in lungs of PETN-treated mice (P=0.0961 for alpha1 and P=0.3709 for beta1). The activities of isolated sGC in response to SNAP (1 microM-1 mM) were identical in aortae of ISMN-treated rabbits (P=0.0775) and lungs of PETN-treated mice (P=0.6348). The aortic relaxation response to SNAP slightly decreased at high ISMN but not at high PETN. CONCLUSIONS AND IMPLICATIONS These data refute the hypothesis that therapeutic treatment with long acting NO donors has a significant impact on the regulation of vascular sGC expression and activity in vivo.
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Affiliation(s)
- M Oppermann
- Institute for Pharmacology and Clinical Pharmacology, Heinrich-Heine-Universität, Düsseldorf, Germany
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Bas M, Yizdiz A, Sezen Y, Gur M, Polat M, Demirbag R, Yilmaz R. NT-PROBNP IN CASES WITH METABOLIC SYNDROME AND THE RELATIONSHIP BETWEEN NT-PROBNP AND CLINICAL AND LABORATORY PARAMETERS. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70531-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Demirbag R, Yildiz A, Sezen Y, Gur M, Bas M, Polat M, Yilmaz R, Cakir H, Ozcan E. THE INFLUENCE OF OXIDATIVE PARAMETERS, PROLIDASE, PARAOXONASE AND ARYLESTERASE ACTIVITIES ON MEAN BLOOD PRESSURE. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70980-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Yildiz A, Yilmaz R, Demirbag R, Gur M, Bas M, Erel O. THE IMPACT OF SERUM URIC ACID LEVEL ON CORONARY BLOOD FLOW. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70270-8] [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: 11/28/2022]
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Abstract
Angioedema is an underestimated clinical problem. Many cases are nonallergic reactions, e.g. bradykinin-induced angioedema caused by genetic defects and angiotensin-converting enzyme (ACE) inhibitors. This difference is crucial for successful therapy, in particular when complete emergency care is not available. Five important forms of nonallergic angioedema can be distinguished: hereditary (HAE), acquired (AAE), renin-angiotensin-aldosterone system (RAAS)-blocker-induced (RAE), pseudoallergic angioedema (PAE) and idiopathic angioedema (IAE). Some angioedema are present in the larynx and may cause death. A vast majority of nonallergic angioedema are RAE, particularly those caused by ACE inhibitors. It appears important to emphasize that in patients with complete intolerance to RAAS-blockers, cessation of RAAS-blockers is likely to be associated with increased cardiovascular risk. Currently, there is no published algorithm for diagnosis and treatment. Angioedema is usually treated by a conservative clinical approach using artificial ventilation, glucocorticoids and antihistamines. Today, a plasma pool C1-esterase inhibitor (C1-INH) concentrate is the therapy of choice in HAE. The current pharmacotherapy of nonallergic angioedema is not satisfactory, thus requiring the identification of effective agents in clinical trials. Recently, several new drugs were developed: a recombinant C1-INH, a kallikrein inhibitor (ecallantide) and a specific bradykinin-B2-receptor antagonist (icatibant). According to currently available reports, these drugs may improve the treatment of kinin-induced angioedema.
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Affiliation(s)
- M Bas
- Hals-, Nasen- und Ohrenklinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
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Abstract
BACKGROUND Hemorrhage after tonsillectomy and adenoidectomy remains a serious complication. Therefore, routine preoperative coagulation screening, including activated partial thromboplastin time (aPTT), prothrombin time (PT) and platelet count (PLC), are regularly performed, also for medicolegal reasons. In the recently published statement of the German Society of Otorhinolaryngology, Head and Neck Surgery the need for routine preoperative coagulation screening is discussed, but so far no standardized procedure had been established. According to this statement - at least for children - routine preoperative coagulation screening is not mandatory as long as the thorough medical history provides no evidence for a coagulation disorder ( http://www.hno.org/kollegen/gerinnung_te_ae.html ). The present study was undertaken to determine the occurrence of postoperative hemorrhage on the one hand, and the incidence of abnormal preoperative routine coagulation parameters or pathological anamnesis findings on the other. PATIENTS AND METHODS In 688 patients, a standardized clinical history was obtained using a questionnaire. Coagulation screening included aPTT, PT, and PLC was also carried out. Bleeding complications were then correlated with anamnesis features and abnormalities in coagulation screening. RESULTS In 39 (5.7%) of the 688 patients we found abnormal coagulation values, which were confirmed in repeated analyses. In six of these a detailed analysis revealed occult coagulation disorders requiring correction only in the case of bleeding complications who were previously unknown. Fifteen patients were already known to have a coagulation disorder, and the anamnesis identified no additional patient at risk. Thus, 21 patients with coagulation disorders requiring correction in the case of a bleeding complication underwent surgery. However, only eight (38%) of these showed abnormal routine coagulation parameters. Surgical treatment of postoperative hemorrhage was required in 12 patients, all of whom had normal values for aPTT, PT and PLC. CONCLUSION The frequently performed determination of routine coagulation parameters (aPTT, PT, PLC) is not able to reliably identify relevant coagulation disorders or to predict the risk for postoperative hemorrhagic complications after adenoidectomy or tonsillectomy.
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Affiliation(s)
- K Scheckenbach
- Klinik für Hals-, Nasen-, Ohren-Krankheiten, Medizinische Einrichtungen der Heinrich Heine-Universität Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Deutschland.
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Affiliation(s)
- M Bas
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Düsseldorf, Moorenstr. 5, D-40225 Düsseldorf, Germany.
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Abstract
Acute drug-induced angioedema is a non-pruritic swelling of subcutaneous and submucosal tissue. It most occur occurs the mouth and larynx as well as lips and eyelids; less often other skin regions or even the gut can be involved. ACE inhibitor (ACEi)- induced angioedema typical occurs after several years on medication. A 72-year-old woman developed recurrent ACEi-induced angioedema. The drug was stopped and she received an AT(1)-receptor antagonist as an alternative antihypertensive. This medication also led to angioedema, which was not immediately recognized as medication-associated. AT(1)-receptor antagonists are not suitable alternatives for ACEi because they also carry an increased risk for inducing angioedema.
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Affiliation(s)
- M-C Hellebrand
- Hals-, Nasen- und Ohrenklinik, Universitätsklinikum Düsseldorf
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Bas M, Greve J, Kojda G, Bier H, Hoffmann T. Crit Care 2006; 10:P315. [DOI: 10.1186/cc4662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Abstract
AIMS This study was designed to identify new factors which may contribute to angiotensin-converting-enzyme-inhibitor (ACEI)-induced angioedema. METHODS In a retrospective cohort study we examined 25 patients who used an ACEI and presented at our emergency room with acute angioedema as well as 18 patients with unknown cause of angioedema and a total of 21 patients on ACEI-therapy without previous angioedema. We measured markers of inflammation such as acute-phase proteins (C-reactive protein, fibrinogen), leukocyte count and body temperature. RESULTS The mean interval between initiation of ACEI treatment and first manifestation of angioedema was 35.8 +/- 5.3 months. During symptomatic angioedema, mean plasma levels of C-reactive protein and fibrinogen were significantly increased by 7.3-fold and 1.5-fold, respectively, while leukocyte count and body temperature were normal. These changes disappeared after successful treatment of angioedema and were not found in patients with angioedema of unknown cause and those receiving ACEI without having experienced angioedema. CONCLUSION Our findings demonstrate for the first time that ACEI-induced angioedema is associated with strongly increased plasma levels of CRP. We suggest that CRP is involved in the pathophysiology of ACEI-induced angioedema.
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Affiliation(s)
- M Bas
- Department of Otorhinolaryngology, Heinrich-Heine University, Düsseldorf, Germany
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Abstract
BACKGROUND Angioedema in the head and neck region is potentially life-threatening and may occur as a side effect of inhibitors of the angiotensin-converting-enzyme (ACEI). So far, little is known about the time between the first application of ACEI and the occurrence of angioedema, or of possible cofactors and laboratory changes. MATERIAL AND METHODS A total of 21 patients with angioedema during the course of ACEI treatment were compared to 11 patients with angioedema of unknown cause. These were retrospectively analysed for the following criteria: (1) duration of ACEI medication, (2) leading and concomitant diseases, (3) history of allergies, (4) co-medication, (5) laboratory changes, (6) treatment success, and (7) manifestation of recurrent episodes. RESULTS The mean interval between the initiation of ACEI therapy and the first occurrence of angioedema exceeded 2 years. Values for the acute phase proteins C-reactive protein (CRP) and fibrinogen were significantly increased in the ACEI group compared to the control group. CONCLUSIONS In any case of angioedema in the head and neck region, a side effect of ACEI must be taken into consideration even if the medication has been taken for months or years.
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Affiliation(s)
- M Bas
- Hals-Nasen-Ohren-Klinik, Universitätsklinikum Düsseldorf
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Bas M, Braunstein S, Haas I, Hoffmann TK. [Swelling of the medial canthus]. HNO 2004; 52:542-4. [PMID: 15014892 DOI: 10.1007/s00106-003-1009-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- M Bas
- Klinik für HNO-Heilkunde, Kopf- und Halschirurgie, Universitätsklinikum Düsseldorf
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Bas M, Wahbe LJ, Bier H, Schulz-Coulon HJ, Wagenmann M, Kojda G, Ivens K, Bantis C, Hoffmann TK. Der I/D-Polymorphismus des Angiotensin-Converting-Enzyme (ACE): Ursache für das ACE-hemmer induzierte Angioödem? Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-823178] [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]
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May M, Zotz RB, Haas I, Bier H, Gerhardt A, Bas M, Hoffmann TK. Veränderung von Akute-Phase-Proteinen und anderer Gerinnungsfaktoren bei Patienten mit Plattenepithelkarzinomen des Kopf-Hals-Bereiches. Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-823515] [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]
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Topbasi B, Gunday M, Bas M, Turkmen C. Two-dimensional photoelastic stress analysis of traumatized incisor. Braz Dent J 2001; 12:81-4. [PMID: 11445918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
In this study, stress of traumatized incisor and the effect of stress on tooth and alveolar bone was studied with two-dimensional photoelasticity. Two homogeneous two-dimensional maxillary central incisor models were prepared. Loads were applied to the labial side of incisal edge and middle third of the crown at angles of 45 degrees and 90 degrees. It was observed that stress was increased on teeth and alveolar bone when load was applied 90 degrees on labial side of incisal edge.
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Affiliation(s)
- B Topbasi
- Department of Restorative Dentistry, Marmara University, Faculty of Dentistry, Buyuk Ciftlik Sok. No: 6 80200 Nisantasi, Istanbul, Turkey.
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Bas M. Medicare at maturity: Achievements, lessons and challenges. Health Policy 1988. [DOI: 10.1016/0168-8510(88)90041-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Timmes JJ, Wolvek S, Fernando M, Bas M, Rocko J. A new method of sternal approximation. AORN J 1973; 18:1135-7. [PMID: 4586718 DOI: 10.1016/s0001-2092(07)63157-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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