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Verbist M, Dubron K, Bila M, Jacobs R, Shaheen E, Willaert R. Accuracy of surgical navigation for patient-specific reconstructions of orbital fractures: A systematic review and meta-analysis. J Stomatol Oral Maxillofac Surg 2024; 125:101683. [PMID: 37951500 DOI: 10.1016/j.jormas.2023.101683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/25/2023] [Accepted: 11/09/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to review the recent literature on the technical accuracy of surgical navigation for patient-specific reconstruction of orbital fractures using a patient-specific implant, and to compare surgical navigation with conventional techniques. MATERIALS AND METHODS A systematic literature search was conducted in PubMed (Medline), Embase, Web of Science, and Cochrane (Core Collection) databases on May 16, 2023. Literature comparing surgical navigation with a conventional method using postoperative three-dimensional computed tomography imaging was collected. Only articles that studied at least one of the following outcomes were included: technical accuracy (angular accuracy, linear accuracy, volumetric accuracy, and degree of enophthalmos), preoperative and perioperative times, need for revision, complications, and total cost of the intervention. MINORS criteria were used to evaluate the quality of the articles. RESULTS After screening 3733 articles, 696 patients from 27 studies were included. A meta-analysis was conducted to evaluate volumetric accuracy and revision rates. Meta-analysis proved a significant better volumetric accuracy (0.93 cm3 ± 0.47 cm3) when surgical navigation was used compared with conventional surgery (2.17 cm3 ± 1.35 cm3). No meta-analysis of linear accuracy, angular accuracy, or enophthalmos was possible due to methodological heterogeneity. Surgical navigation had a revision rate of 4.9%, which was significantly lower than that of the conventional surgery (17%). Costs were increased when surgical navigation was used. CONCLUSION Studies with higher MINORS scores demonstrated enhanced volumetric precision compared with traditional approaches. Surgical navigation has proven effective in reducing revision rates compared to conventional approaches, despite increased costs.
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Affiliation(s)
- Maarten Verbist
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS IMPATH Research Group, Department of Imaging & Pathology, University Hospitals Leuven, Belgium.
| | - Kathia Dubron
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS IMPATH Research Group, Department of Imaging & Pathology, University Hospitals Leuven, Belgium
| | - Michel Bila
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS IMPATH Research Group, Department of Imaging & Pathology, University Hospitals Leuven, Belgium
| | - Reinhilde Jacobs
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS IMPATH Research Group, Department of Imaging & Pathology, University Hospitals Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Eman Shaheen
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS IMPATH Research Group, Department of Imaging & Pathology, University Hospitals Leuven, Belgium
| | - Robin Willaert
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS IMPATH Research Group, Department of Imaging & Pathology, University Hospitals Leuven, Belgium
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Gao Y, Gu Y, Dessel JV, Lübbers HT, Tian L, Politis C, Bila M, Willaert R, Chen X, Sun Y. OrthoCalc: The six degrees of freedom measurement workflow of rotational and displacement changes for maxilla positioning evaluation. Comput Methods Programs Biomed 2024; 247:108083. [PMID: 38402715 DOI: 10.1016/j.cmpb.2024.108083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/12/2024] [Accepted: 02/15/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND This study is undertaken to establish the accuracy and reliability of OrthoCalc, a 3D application designed for the evaluation of maxillary positioning. METHODS We registered target virtual planned models, maxillary models from pre-operative and post-operative CT scans, and post-operative intra-oral scans to a common reference system, allowing for digital evaluation. To assess rotational changes, we introduced a novel measurement method based on virtual cuboid models. Displacement errors were calculated based on proposed registration matrices. We also compared OrthoCalc to established commercial medical software as a benchmark. RESULTS Statistical significance calculated showed no significant differences between OrthoCalc and commercial software. the biggest error of 0.04 degree in rotation change was found in the yaw. A maximum displacement change of 0.75 mm was found in the X direction. CONCLUSIONS Our study validates OrthoCalc as a precise and reliable tool for assessing maxillary position changes with six degrees of freedom in orthognathic surgery, endorsing its clinical utility.
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Affiliation(s)
- Yao Gao
- The Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium
| | - Yifei Gu
- The Fourth Affiliated Hospital of Soochow University, PR China
| | - Jeroen Van Dessel
- The Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium
| | - Heinz-Theo Lübbers
- Clinic for Cranio-Maxillofacial Surgery, University Hospital of Zurich, Frauenklinikstrasse 24, Zurich CH-8091, Switzerland; Harvard Medical School, Brigham and Women's Hospital, Surgical Planning Laboratory, Francis Street 75, Boston, MA 02115, USA
| | - Lei Tian
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, 145 West Changle Road, Xi'an 710032, PR China
| | - Constantinus Politis
- The Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium
| | - Michel Bila
- The Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium
| | - Robin Willaert
- The Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium
| | - Xiaojun Chen
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, PR China; Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, PR China
| | - Yi Sun
- The Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium.
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De Moor A, Dormaar JT, Willaert R. Congenital Unilateral Zygomaticomaxillomandibular Fusion in a 4-year-old Girl. Plast Reconstr Surg Glob Open 2024; 12:e5677. [PMID: 38655104 PMCID: PMC11037728 DOI: 10.1097/gox.0000000000005677] [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: 11/13/2023] [Accepted: 01/30/2024] [Indexed: 04/26/2024]
Abstract
Congenital zygomaticomaxillomandibular (ZMM) fusion is an extremely rare and debilitating condition. Fusion of the jaws results in a severe limitation of the mouth opening accompanied by breathing and feeding difficulties. Mandibular fusions to the maxilla, palate, zygoma, and temporal bone are described in literature. We present the case of 4-year-old girl diagnosed with congenital unilateral ZMM fusion. She was treated surgically at 1 year and at 4 and a half years to release the fusion and to improve mouth opening. Second surgery was indicated due to recurrence. Management of young patients with congenital maxillomandibular fusion is challenging. The scarcity of cases makes formulating practice guidelines very difficult. If surgery is performed, the importance of postoperative physical therapy cannot be overstated. The goal of this article is to emphasize the risk of recurrence in ZMM fusion after surgical treatment and importance of regular follow-up.
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Affiliation(s)
- Alexander De Moor
- From the Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Jakob Titiaan Dormaar
- From the Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, Radboud University Hospital, Nijmegen, The Netherlands
| | - Robin Willaert
- From the Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
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Dubron K, Yang LH, Jacobs R, Politis C, Willaert R, Shaheen E. Symmetry recovery in zygomaticomaxillary complex fractures compared to normal unfractured population: A new reliable 3D evaluation. J Stomatol Oral Maxillofac Surg 2024:101857. [PMID: 38556166 DOI: 10.1016/j.jormas.2024.101857] [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: 01/13/2024] [Revised: 03/12/2024] [Accepted: 03/29/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVE This study aims to quantify the facial symmetry of surgically treated zygomaticomaxillary complex (ZMC) fractures through a new reliable three-dimensional evaluation method, which is crucial for improving post-operative aesthetic and functional outcomes. MATERIAL AND METHODS Healthy patients and patients with surgically treated ZMC fractures were retrospectively reviewed. Using Brainlab Elements® the zygomatic bone and the orbit of each patient was segmented and mirrored. Subsequently, the mirrored side was matched with the other side via volume-based registration, using the segmented orbit as reference. Volumetric asymmetry was measured using 3-matic software, and a surface-based matching technique was used to calculate the mean absolute differences (MAD) between the surfaces of the two sides of the ZMC. The reliability of this novel method using volume-based registration was tested, and the intra-class correlation coefficient was assessed. RESULTS The MAD between the surfaces of the left and right sides in the control group was 0.51 mm (±0.09). As for the ZMC fracture group, MAD was 0.78 mm (±0.20) and 0.72 mm (±0.15) pre- and post-operatively, respectively. The MAD showed statistically significant differences between pre- and post-operative groups (p = 0.005) and between control and post-operative groups (p < 0.001). The intra-class correlation coefficient was high (≥0.99). CONCLUSIONS This evaluation method using mirroring and volume-based registration to determine the symmetrical position of the ZMC is reliable. The surface-based measurements revealed an improved symmetry after surgery. However, the symmetry of the treated patients remained lower than the control group.
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Affiliation(s)
- K Dubron
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS IMPATH Research Group, Department of Imaging & Pathology, University Hospitals Leuven, Belgium
| | - L H Yang
- Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Belgium
| | - R Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, University Hospitals Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - C Politis
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS IMPATH Research Group, Department of Imaging & Pathology, University Hospitals Leuven, Belgium
| | - R Willaert
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS IMPATH Research Group, Department of Imaging & Pathology, University Hospitals Leuven, Belgium
| | - E Shaheen
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS IMPATH Research Group, Department of Imaging & Pathology, University Hospitals Leuven, Belgium
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Bila M, Franken A, Van Dessel J, Garip M, Meulemans J, Willaert R, Hoeben A, Vander Poorten V, Clement PM. Exploring long-term responses to immune checkpoint inhibitors in recurrent and metastatic head and neck squamous cell carcinoma. Oral Oncol 2024; 149:106664. [PMID: 38113661 DOI: 10.1016/j.oraloncology.2023.106664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVES Immune checkpoint inhibitors (ICI) have introduced a new era in the treatment of recurrent and/or metastatic head and neck squamous cell carcinoma (R/M HNSCC). Optimal duration for ICI therapy is still unclear and the long-term outcomes and toxicity in patients responding to these therapies warrant further exploration. This study attempts to identify the clinical and biological determinants of a durable response and evaluate outcomes following ICI treatment discontinuation. MATERIALS AND METHODS A retrospective review of 181 patients treated with ICI for R/M HNSCC was conducted. Long-term responders were defined as patients who sustained disease control at least two years after initiating ICI therapy. We compared clinical and biological characteristics associated with these long-term responders against the broader treatment population. RESULTS 10 % of R/M HNSCC patients treated with ICIs demonstrated a durable long-term response. Only three relapses (16 %) occurred after discontinuing ICI treatment in this subset, with a median follow-up of 52 months. Upon retreatment with ICI, two attained a documented response. Extended ICI response was observed even with < 2 years of treatment. 74 % of long-term responders experienced immune-related adverse events (irAEs), 37 % of which severe irAEs. Hypothyroidism was the most frequently reported irAEs. The predictive potential of systemic inflammation indices for clinical response appears to be limited. CONCLUSIONS ICI present an optimistic avenue for HNSCC patients, offering substantial long-term responses. The study suggests that a two-year treatment could be optimal and irAEs, although common, are typically mild.
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Affiliation(s)
- Michel Bila
- Oral and maxillofacial surgery, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, Leuven Cancer Institute, KU Leuven, Leuven, Belgium.
| | - Amelie Franken
- Laboratory for Translational Genetics, Department of Human Genetics, KU Leuven, Leuven, Belgium; VIB Center for Cancer Biology, Leuven, Belgium
| | - Jeroen Van Dessel
- Oral and maxillofacial surgery, University Hospitals Leuven, Leuven, Belgium; Department of Oral and Maxillo-facial Surgery - Imaging & Pathology (OMFS-IMPATH), KU Leuven, Leuven, Belgium
| | - Melisa Garip
- Oral and maxillofacial surgery, University Hospitals Leuven, Leuven, Belgium
| | - Jeroen Meulemans
- Otorhinolaryngology, Head and Neck surgery, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Robin Willaert
- Oral and maxillofacial surgery, University Hospitals Leuven, Leuven, Belgium; Department of Oral and Maxillo-facial Surgery - Imaging & Pathology (OMFS-IMPATH), KU Leuven, Leuven, Belgium
| | - Ann Hoeben
- Division of Medical Oncology, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; GROW-School of Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Vincent Vander Poorten
- Otorhinolaryngology, Head and Neck surgery, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Paul M Clement
- Department of Oncology, Leuven Cancer Institute, KU Leuven, Leuven, Belgium; Medical oncology, University Hospitals Leuven, Leuven, Belgium
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Dubron K, Verbist M, Jacobs R, Olszewski R, Shaheen E, Willaert R. Augmented and Virtual Reality for Preoperative Trauma Planning, Focusing on Orbital Reconstructions: A Systematic Review. J Clin Med 2023; 12:5203. [PMID: 37629251 PMCID: PMC10455745 DOI: 10.3390/jcm12165203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 07/28/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND This systematic review summarizes recent literature on the use of extended reality, including augmented reality (AR), mixed reality (MR), and virtual reality (VR), in preoperative planning for orbital fractures. METHODS A systematic search was conducted in PubMed, Embase, Web of Science and Cochrane on 6 April 2023. The included studies compared extended reality with conventional planning techniques, focusing on computer-aided surgical simulation based on Computed Tomography data, patient-specific implants (PSIs), fracture reconstruction of the orbital complex, and the use of extended reality. Outcomes analyzed were technical accuracy, planning time, operative time, complications, total cost, and educational benefits. RESULTS A total of 6381 articles were identified. Four articles discussed the educational use of VR, while one clinical prospective study examined AR for assisting orbital fracture management. CONCLUSION AR was demonstrated to ameliorate the accuracy and precision of the incision and enable the better identification of deep anatomical tissues in real time. Consequently, intraoperative imaging enhancement helps to guide the orientation of the orbital reconstruction plate and better visualize the precise positioning and fixation of the PSI of the fractured orbital walls. However, the technical accuracy of 2-3 mm should be considered. VR-based educational tools provided better visualization and understanding of craniofacial trauma compared to conventional 2- or 3-dimensional images.
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Affiliation(s)
- Kathia Dubron
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, 3000 Leuven, Belgium
- OMFS IMPATH Research Group, Department of Imaging & Pathology, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, Cliniques Universitaires Saint Luc, UCLouvain, Av. Hippocrate 10, 1200 Brussels, Belgium
| | - Maarten Verbist
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of Dental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Raphael Olszewski
- Department of Oral and Maxillofacial Surgery, Cliniques Universitaires Saint Luc, UCLouvain, Av. Hippocrate 10, 1200 Brussels, Belgium
- Oral and Maxillofacial Surgery Research Lab (OMFS Lab), NMSK, Institut de Recherche Expérimentale et Clinique (IREC), SSS, UCLouvain, 1200 Brussels, Belgium
| | - Eman Shaheen
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, 3000 Leuven, Belgium
- OMFS IMPATH Research Group, Department of Imaging & Pathology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Robin Willaert
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, 3000 Leuven, Belgium
- OMFS IMPATH Research Group, Department of Imaging & Pathology, University Hospitals Leuven, 3000 Leuven, Belgium
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Leyman B, Govaerts D, Dormaar JT, Meeus J, Bila M, Coropciuc R, Willaert R, Politis C. A 16-year retrospective study of vascular anomalies in the head and neck region. Head Face Med 2023; 19:32. [PMID: 37528467 PMCID: PMC10391867 DOI: 10.1186/s13005-023-00376-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 06/30/2023] [Indexed: 08/03/2023] Open
Abstract
Depending on the diagnostic modality, the classification of vascular anomalies varies and so does the nomenclature. The 'International Society for the Study of Vascular Anomalies' (ISSVA) is the most widely accepted classification in the literature and is mainly based on the radiologic and clinical presentation. The aim of this article is to review the clinical practice of diagnosis and treatment of vascular anomalies in the head and neck region in a university hospital, with special focus on the nomenclature. All patients with a vascular anomaly presenting to the department of oral and maxillofacial surgery were reviewed in a retrospective manner. Nomenclature, diagnostic process, lesion characteristics, treatment and outcome were examined. The lesions were (re)classified according to the ISSVA classification. A total of 185 patients were identified, of which 12.4% (n = 23) had a congenital anomaly. After reclassification, the most common lesions were venous malformations (n = 47, 25.4%), followed by lobular capillary hemangiomas (n = 17, 9.2%). A group of 39 anomalies could not be further specified. One hundred and one patients (54,6%) received treatment, of which 93 were treated surgically (92,1% of treated patients). Endovascular treatment was considered in 41 patients but applied in only eight. This strict selection led to a low a complication rate. We provide an overview of the clinical practice in the management of vascular anomalies in a university hospital. The histology report is a source of miscommunication because clinicians use the ISSVA classification, while pathologists use the WHO classification. Every professional involved should be aware of the differences in classification and nomenclature.
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Affiliation(s)
- Bernard Leyman
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium.
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium.
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
| | - Dries Govaerts
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Jakob Titiaan Dormaar
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
- Present Address: Radboudumc, Geert Grooteplein Zuid 10, Nijmegen, The Netherlands
| | - Jan Meeus
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Michel Bila
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Ruxandra Coropciuc
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Robin Willaert
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Constantinus Politis
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
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Vercruysse M, Willaert R, Goormans F, Coropciuc R, Politis C. Indications and complications regarding titanium osteosynthesis in pediatric maxillofacial trauma: A scoping review and critical appraisal. J Stomatol Oral Maxillofac Surg 2023; 124:101284. [PMID: 36108919 DOI: 10.1016/j.jormas.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/30/2022] [Accepted: 09/05/2022] [Indexed: 11/19/2022]
Abstract
With the advent of biodegradable osteosynthesis material, titanium osteosynthesis for ORIF in pediatric maxillofacial trauma is not as indisputable as before. The aim of this study was to conduct a scoping review to assess the indications, complications of ORIF with titanium osteosynthesis material in pediatric maxillofacial trauma. A systematic search was conducted in PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, gray literature (ICTRP and clinicaltrials.gov) for studies published until April 2022. 3436 studies were screened and finally 13 articles, compromising a sample of 340 pediatric patients were included after full text reading. Reported complications were infection (6.5% of population), malocclusion (5% of population) and dental maleruption (8% of population). Influence on future growth could not be assessed due to short and heterogeneous follow-up periods. Eight of the thirteen studies concluded to a positive and predictable outcome using titanium ORIF for displaced/complex pediatric maxillofacial fractures. Results of this review suggest that titanium ORIF for maxillofacial fractures in the pediatric population is a reliable treatment. The surgeon must be committed to following these patients longitudinally. Interpreting the results should, however, be done with great care, as most articles have a medium to high risk of bias and limited follow-up.
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Affiliation(s)
- Maximilien Vercruysse
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
| | - Robin Willaert
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Imaging and Pathology, Faculty of Medicine, OMFS/IMPATH Research Group, KU Leuven, Leuven, Belgium
| | - Femke Goormans
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Ruxandra Coropciuc
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Imaging and Pathology, Faculty of Medicine, OMFS/IMPATH Research Group, KU Leuven, Leuven, Belgium
| | - Constantinus Politis
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Imaging and Pathology, Faculty of Medicine, OMFS/IMPATH Research Group, KU Leuven, Leuven, Belgium
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9
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Peeters F, Van Dessel J, Croonenborghs TM, Smeets M, Sun Y, Willaert R, Politis C, Bila M. Value of six comorbidity scales for predicting survival of patients with primary surgery for oral squamous cell carcinoma. Head Neck 2022; 44:1142-1152. [PMID: 35194882 DOI: 10.1002/hed.27015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 02/02/2022] [Accepted: 02/14/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Comorbidities influence treatment outcome of oral squamous cell carcinoma (OSCC). This study compared the predictive performance of six comorbidity scales for overall survival after surgery for OSCC. METHODS We retrospectively analyzed OSCC patients, surgically treated at an academic center in Belgium between January 01, 2000 and January 01, 2020. Validity of the scales was evaluated using the area under the curve (AUC) of receiver operating characteristic curves. RESULTS Three hundred and twenty three patients were included. Elixhauser Comorbidity Index (AUC = 0.74, 95% CI: 0.55-0.92; AUC = 0.73, 95% CI: 0.55-0.80), modified Elixhauser Comorbidity Index (AUC = 0.72, 95% CI: 0.54-0.91; AUC = 0.69, 95% CI: 0.51-0.77), and Combined Comorbidity Index (AUC = 0.76, 95% CI: 0.58-0.84; AUC = 0.76, 95% CI: 0.59-0.84) were meaningful predictors for 2 and 5-year survival, respectively. CONCLUSION Selected comorbidity scales were capable of predicting overall survival for OSCC patients 2 and 5 years after primary surgery.
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Affiliation(s)
- Frederik Peeters
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Jeroen Van Dessel
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Tomas-Marijn Croonenborghs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Maximiliaan Smeets
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Yi Sun
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Robin Willaert
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Constantinus Politis
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Michel Bila
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
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10
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Thijssen Q, Cornelis K, Alkaissy R, Locs J, Damme LV, Schaubroeck D, Willaert R, Snelling S, Mouthuy PA, Van Vlierberghe S. Tough Photo-Cross-Linked PCL-Hydroxyapatite Composites for Bone Tissue Engineering. Biomacromolecules 2022; 23:1366-1375. [PMID: 35147420 DOI: 10.1021/acs.biomac.1c01584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Acrylate-based photo-cross-linked poly(ε-caprolactone) (PCL) tends to show low elongation and strength. Incorporation of osteo-inductive hydroxyapatite (HAp) further enhances this effect, which limits its applicability in bone tissue engineering. To overcome this, the thiol-ene click reaction is introduced for the first time in order to photo-cross-link PCL composites with 0, 10, 20, and 30 wt % HAp nanoparticles. It is demonstrated that the elongation at break and ultimate strength increase 10- and 2-fold, respectively, when the photopolymerization mechanism is shifted from a radical chain-growth (i.e., acrylate cross-linking) toward a radical step-growth polymerization (i.e., thiol-ene cross-linking). Additionally, it is illustrated that osteoblasts can attach to and proliferate on the surface of the photo-cross-linked PCL-HAp composites. Finally, the incorporation of HAp nanoparticles is shown to reduce the ALP activity of osteoblasts. Overall, thiol-ene cross-linked PCL-HAp composites can be considered as promising potential materials for bone tissue engineering.
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Affiliation(s)
- Quinten Thijssen
- Polymer Chemistry and Biomaterials Group, Centre of Macromolecular Chemistry, Department of Organic and Macromolecular Chemistry, Ghent University, Krijgslaan 281 S4, 9000 Ghent, Belgium
| | - Kim Cornelis
- Polymer Chemistry and Biomaterials Group, Centre of Macromolecular Chemistry, Department of Organic and Macromolecular Chemistry, Ghent University, Krijgslaan 281 S4, 9000 Ghent, Belgium
| | - Rand Alkaissy
- Nuffield department of Orthopaedics Rheumatology and Musculoskeletal Sciences (NDORMS), B4495, Headington, Oxford OX3 7LD, United Kingdom
| | - Janis Locs
- Rudolfs Cimdins Riga Biomaterials Innovation and Development Centre, Institute of General Chemical Engineering, Faculty of Materials Science and Applied Chemistry, Riga Technical University, Pulka 3, Riga LV-1007, Latvia.,Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, Riga LV-1658, Latvia
| | - Lana Van Damme
- Polymer Chemistry and Biomaterials Group, Centre of Macromolecular Chemistry, Department of Organic and Macromolecular Chemistry, Ghent University, Krijgslaan 281 S4, 9000 Ghent, Belgium
| | - David Schaubroeck
- Centre for Microsystems Technology (CMST), imec and Ghent University, Technologiepark-Zwijnaarde 126, 9052 Ghent, Belgium
| | - Robin Willaert
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Sarah Snelling
- Nuffield department of Orthopaedics Rheumatology and Musculoskeletal Sciences (NDORMS), B4495, Headington, Oxford OX3 7LD, United Kingdom
| | - Pierre-Alexis Mouthuy
- Nuffield department of Orthopaedics Rheumatology and Musculoskeletal Sciences (NDORMS), B4495, Headington, Oxford OX3 7LD, United Kingdom
| | - Sandra Van Vlierberghe
- Polymer Chemistry and Biomaterials Group, Centre of Macromolecular Chemistry, Department of Organic and Macromolecular Chemistry, Ghent University, Krijgslaan 281 S4, 9000 Ghent, Belgium
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11
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Pinheiro M, Krairi A, Willaert R, Costa MC, Van Paepegem W. Structural optimization of patient-specific temporomandibular joint replacement implants for additive manufacturing: novel metrics for safety evaluation and biomechanical performance. Biodes Manuf 2022. [DOI: 10.1007/s42242-021-00174-z] [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: 11/30/2022]
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12
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Pinheiro M, Willaert R, Khan A, Krairi A, Van Paepegem W. Biomechanical evaluation of the human mandible after temporomandibular joint replacement under different biting conditions. Sci Rep 2021; 11:14034. [PMID: 34234245 PMCID: PMC8263622 DOI: 10.1038/s41598-021-93564-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 06/22/2021] [Indexed: 01/01/2023] Open
Abstract
Temporomandibular joint (TMJ) replacement with an implant is only used when all other conservative treatments fail. Despite the promising short-term results, the long-term implications of TMJ replacement in masticatory function are not fully understood. Previous human and animal studies have shown that perturbations to the normal masticatory function can lead to morphological and functional changes in the craniomaxillofacial system. A clearer understanding of the biomechanical implications of TMJ replacement in masticatory function may help identify design shortcomings that hinder their long-term success. In this study, patient-specific finite element models of the intact and implanted mandible were developed and simulated under four different biting tasks. In addition, the impact of re-attaching of the lateral pterygoid was also evaluated. The biomechanics of both models was compared regarding both mandibular displacements and principal strain patterns. The results show an excessive mediolateral and anteroposterior displacement of the TMJ implant compared to the intact joint in three biting tasks, namely incisor (INC), left moral (LML), and right molar (RML) biting. The main differences in principal strain distributions were found across the entire mandible, most notably from the symphysis to the ramus of the implanted side. Furthermore, the re-attachment of the lateral pterygoid seems to increase joint anteroposterior displacement in both INC, LML and RML biting while reducing it during LGF. Accordingly, any new TMJ implant design must consider stabilising both mediolateral and anteroposterior movement of the condyle during biting activities and promoting a more natural load transmission along the entire mandible.
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Affiliation(s)
- Manuel Pinheiro
- Department of Materials, Textiles and Chemical Engineering, Mechanics of Materials and Structures (MMS), Ghent University, Ghent, Belgium.
| | - Robin Willaert
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Head and Neck Surgery, Ghent University Hospital, Ghent, Belgium
| | - Afaq Khan
- Materials Innovation Institute (M2i), Delft, The Netherlands
- Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - Anouar Krairi
- Materials Innovation Institute (M2i), Delft, The Netherlands
| | - Wim Van Paepegem
- Department of Materials, Textiles and Chemical Engineering, Mechanics of Materials and Structures (MMS), Ghent University, Ghent, Belgium
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13
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da Costa Senior O, Smeets M, Willaert R, Shaheen E, Jacobs R, Politis C. Complications Following One-Stage Versus Two-Stage Surgical Treatment of Transverse Maxillary Hypoplasia. J Oral Maxillofac Surg 2021; 79:1531-1539. [PMID: 33757746 DOI: 10.1016/j.joms.2021.02.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/18/2021] [Accepted: 02/18/2021] [Indexed: 01/11/2023]
Abstract
PURPOSE Contemporary literature suggests a similar transverse stability of a surgical-assisted rapid palatal expansion and a segmented Le Fort I osteotomy. The aim of this study was to compare postoperative complications of 1-stage (segmental maxillary osteotomy) and 2-stage (surgical-assisted rapid palatal expansion followed by Le Fort I osteotomy) treated patients to determine the preferred treatment strategy. MATERIALS AND METHODS This retrospective study included 74 consecutive patients (age range: 14 - 57 years; 36 males, 38 females) with a moderate transverse maxillary hypoplasia: 32 patients were treated in a 1-stage protocol and 42 in a 2-stage protocol with a postoperative follow-up of at least 1 year. Dental complications such as loss of teeth, gingival dehiscence, periodontal bone loss, apical root resorption, and surgical complications such as pain, hemorrhage, altered neurosensitivity, wound infection, aseptic necrosis were analyzed. Univariate analysis consisted of a generalized linear model with logit link or Fisher exact test. RESULTS No significant difference was found for group characteristics except for longer orthodontic treatment time in the 2-stage group. Incidence and severity of complications were comparable for the 1-stage and 2-stage patients. Only overall pain was significantly greater in the 2-stage patient group (P = .038). CONCLUSIONS Considering a similar complication rate and transversal stability, the choice between 1-stage and 2-stage approach for patients with a moderate transverse maxillary hypoplasia should be patient specific.
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Affiliation(s)
- Oliver da Costa Senior
- Junior Resident, University Hospitals Leuven, Campus Sint-Rafaël, Department of Oral and Maxillofacial Surgery, Leuven, Belgium; and OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium.
| | - Maximiliaan Smeets
- Junior Resident, University Hospitals Leuven, Campus Sint-Rafaël, Department of Oral and Maxillofacial Surgery, Leuven, Belgium; and OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
| | - Robin Willaert
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium; and Member of Staff, University Hospitals Leuven, Campus Sint-Rafaël, Department of Oral and Maxillofacial Surgery, Leuven, Belgium
| | - Eman Shaheen
- Engineer, OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium; and Department Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Constantinus Politis
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium; and Head of Department, Professor, University Hospitals Leuven, Campus Sint-Rafaël, Department of Oral and Maxillofacial Surgery, Leuven, Belgium
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14
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Shaheen E, Willaert R, Miclotte I, Coropciuc R, Bila M, Politis C. A novel fully automatic design approach of a 3D printed face specific mask: Proof of concept. PLoS One 2020; 15:e0243388. [PMID: 33270772 PMCID: PMC7720797 DOI: 10.1371/journal.pone.0243388] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 11/20/2020] [Indexed: 11/30/2022] Open
Abstract
The use of high quality facemasks is indispensable in the light of the current COVID
pandemic. This study proposes a fully automatic technique to design a face specific mask.
Through the use of stereophotogrammetry, computer-assisted design and three-dimensional
(3D) printing, we describe a protocol for manufacturing facemasks perfectly adapted to the
individual face characteristics. The face specific mask was compared to a universal design
of facemask and different filter container’s designs were merged with the mask body.
Subjective assessment of the face specific mask demonstrated tight closure at the nose,
mouth and chin area, and permits the normal wearing of glasses. A screw-drive locking
system is advised for easy assembly of the filter components. Automation of the process
enables high volume production but still allows sufficient designer interaction to answer
specific requirements. The suggested protocol can be used to provide more comfortable,
effective and sustainable solution compared to a single use, standardized mask. Subsequent
research on printing materials, sterilization technique and compliance with international
regulations will facilitate the introduction of the face specific mask in clinical
practice as well as for general use.
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Affiliation(s)
- Eman Shaheen
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven,
Leuven, Belgium
- Department of Imaging and Pathology, OMFS IMPATH Research Group, Faculty of
Medicine, KU Leuven, Leuven, Belgium
- * E-mail:
| | - Robin Willaert
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven,
Leuven, Belgium
- Department of Imaging and Pathology, OMFS IMPATH Research Group, Faculty of
Medicine, KU Leuven, Leuven, Belgium
| | - Isabel Miclotte
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven,
Leuven, Belgium
- Department of Imaging and Pathology, OMFS IMPATH Research Group, Faculty of
Medicine, KU Leuven, Leuven, Belgium
| | - Ruxandra Coropciuc
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven,
Leuven, Belgium
- Department of Imaging and Pathology, OMFS IMPATH Research Group, Faculty of
Medicine, KU Leuven, Leuven, Belgium
| | - Michel Bila
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven,
Leuven, Belgium
- Department of Imaging and Pathology, OMFS IMPATH Research Group, Faculty of
Medicine, KU Leuven, Leuven, Belgium
| | - Constantinus Politis
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven,
Leuven, Belgium
- Department of Imaging and Pathology, OMFS IMPATH Research Group, Faculty of
Medicine, KU Leuven, Leuven, Belgium
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15
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Willaert R, Degrieck B, Orhan K, Deferm J, Politis C, Shaheen E, Jacobs R. Semi-automatic magnetic resonance imaging based orbital fat volumetry: reliability and correlation with computed tomography. Int J Oral Maxillofac Surg 2020; 50:416-422. [PMID: 32814653 DOI: 10.1016/j.ijom.2020.07.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 01/26/2020] [Revised: 04/19/2020] [Accepted: 07/23/2020] [Indexed: 12/22/2022]
Abstract
Post-processing analysis can provide valuable information for diagnosis and planning of orbital disorders. This cross-sectional study aims to evaluate the reliability of semi-automatic, orbital fat volumetry using magnetic resonance imaging (MRI). Two observers assessed the orbital fat volume using a standard MRI protocol (3T, T1w sequence) in 12 orbits diagnosed with Graves' orbitopathy (GO) and 10 healthy control orbits. MRI and computed tomography (CT) based analysis were compared. Intra-observer variability was good (intraclass correlation coefficient (ICC) 0.88; 95% confidence interval (CI) [0.70, 0.95]) and interobserver agreement was moderate (ICC 0.55; 95% CI [-0.09, 0.81]), which corresponds to a mean percentage difference of 1.3% and 17.9% of the total orbital fat volume. Mean differences between MRI and CT measurements were, respectively, 1.1 cm3 (P= 0.064, 95% CI [-0.20, 2.43]) and 1.4 cm3 (P=0.016, 95% CI [0.21, 2.56]) for the control and the GO group. MRI volumetry was strongly correlated with CT (Pearson's r= 0.7, P<0.001). We conclude that orbital fat volumetry is feasible with a semi-automatic segmentation procedure and standard MRI protocol. Correlation with CT volumetry is good, but considerable bias may derive from observer variability and these errors should be taken into account for the purpose of volumetric analysis. Better definition of error sources may increase measurement accuracy.
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Affiliation(s)
- R Willaert
- Department of Head and Neck Surgery, Ghent University Hospital, Ghent, Belgium; Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
| | - B Degrieck
- Department of Radiology, Ghent University Hospital, Ghent, Belgium
| | - K Orhan
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium; Ankara University, Faculty of Dentistry, Department of DentoMaxillofacial Radiology, Ankara, Turkey
| | - J Deferm
- Department of Oral and Maxillofacial Surgery, Radboud UMC, Nijmegen, The Netherlands
| | - C Politis
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - E Shaheen
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - R Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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16
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Deferm JT, Baan F, Schreurs R, Willaert R, Maal T, Meijer G. Digital surface scanning in flap perfusion. Int J Oral Maxillofac Surg 2020; 50:38-42. [PMID: 32593512 DOI: 10.1016/j.ijom.2020.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 04/05/2020] [Accepted: 05/21/2020] [Indexed: 10/24/2022]
Abstract
Monitoring vascular perfusion of transferred tissue is essential in reconstructive surgery to recognize early flap failure. The aim of this study was to evaluate the ability of a digital surface scanner to detect vascular perfusion disorders through the monitoring of skin colour changes. A total of 160 surface scans of the forearm skin were performed with a TRIOS 3D scanner. Vascular compromise was simulated at different time-points by intermittent occlusion of the blood supply to the forearm skin (first the arterial blood supply and then the venous blood supply). Skin colour changes were examined according to the hue, saturation, and value colour scale. Colour differences were analysed with a paired t-test. Significant differences were observed between the colour of the normal skin and that of the vascular compromised skin (P<0.01). The surface scanner could distinguish between arterial occlusion and venous congestion (P<0.01). A digital surface scan is an objective, non-invasive tool to detect early vascular perfusion disorders of the skin.
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Affiliation(s)
- J T Deferm
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
| | - F Baan
- Department of Orthodontics and Craniofacial Biology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Radboudumc 3D Lab, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - R Schreurs
- Radboudumc 3D Lab, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Department of Oral and Maxillofacial Surgery, Amsterdam UMC Location AMC and Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands
| | - R Willaert
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Head and Neck Surgery, Ghent University Hospital, Ghent, Belgium
| | - T Maal
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Radboudumc 3D Lab, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - G Meijer
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Department of Implantology and Periodontology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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17
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Willaert R, Shaheen E, Deferm J, Vermeersch H, Jacobs R, Mombaerts I. Three-dimensional characterisation of the globe position in the orbit. Graefes Arch Clin Exp Ophthalmol 2020; 258:1527-1532. [PMID: 32140924 DOI: 10.1007/s00417-020-04631-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/09/2020] [Accepted: 02/14/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE Current methods to analyse the globe position, including Hertel exophthalmometry and computed tomography (CT), are limited to the axial plane and require the lateral orbital rim and cornea as landmarks. This pilot study aimed to design a method to measure the position of the globe in the axial, coronal and sagittal plane and independent from orbital bony and corneal references. METHODS With the aid of three-dimensional CT reconstruction technology, we determined the globe position in the orbit based on the centre of the globe. Method validation was performed using data of consecutive orbital CT scans from the control group and from the patients with Graves' orbitopathy who underwent orbital decompression surgery with removal of the lateral orbital margin. RESULTS The inter- and intra-observer reliability was excellent with a high intraclass correlation coefficient (> 0.99, 95% CI [0.97; 1.00]). In the decompressed orbits, there was a statistically significant globe position shift along the anterior-posterior axis (P = 0.0005, 95% CI [0.63; 3.66]), but not along the medial-lateral and superior-inferior axis. CONCLUSION The 3D CT method can accurately and reliably characterise the globe position shift in the three dimensions without using orbital and corneal anatomical landmarks. The method can be useful to determine the globe shift in proptosis, enophthalmos, hypoglobus and hyperglobus, even in the presence of strabismus and orbital bone defects.
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Affiliation(s)
- Robin Willaert
- Department of Head and Neck Surgery, Ghent University Hospital, Ghent, Belgium. .,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
| | - Eman Shaheen
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.,OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Julie Deferm
- Department of Oral and Maxillofacial Surgery, Radboud University Hospital, Nijmegen, The Netherlands
| | - Hubert Vermeersch
- Department of Plastic and Reconstructive Surgery, Ghent University Hospital, Ghent, Belgium
| | - Reinhilde Jacobs
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.,OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Ilse Mombaerts
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
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18
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Willaert R, Nevens D, Laenen A, Batstone M, Politis C, Nuyts S. Does intensity-modulated radiation therapy lower the risk of osteoradionecrosis of the jaw? A long-term comparative analysis. Int J Oral Maxillofac Surg 2019; 48:1387-1393. [DOI: 10.1016/j.ijom.2019.04.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 04/05/2019] [Accepted: 04/21/2019] [Indexed: 10/26/2022]
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19
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van den Akker WMR, Brummelman I, Martis LM, Timmermans RN, Pfundt R, Kleefstra T, Willemsen MH, Gerkes EH, Herkert JC, van Essen AJ, Rump P, Vansenne F, Terhal PA, van Haelst MM, Cristian I, Turner CE, Cho MT, Begtrup A, Willaert R, Fassi E, van Gassen KLI, Stegmann APA, de Vries BBA, Schuurs-Hoeijmakers JHM. De novo variants in CDK13 associated with syndromic ID/DD: Molecular and clinical delineation of 15 individuals and a further review. Clin Genet 2019; 93:1000-1007. [PMID: 29393965 DOI: 10.1111/cge.13225] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 01/03/2018] [Accepted: 01/24/2018] [Indexed: 01/06/2023]
Abstract
De novo variants in the gene encoding cyclin-dependent kinase 13 (CDK13) have been associated with congenital heart defects and intellectual disability (ID). Here, we present the clinical assessment of 15 individuals and report novel de novo missense variants within the kinase domain of CDK13. Furthermore, we describe 2 nonsense variants and a recurrent frame-shift variant. We demonstrate the synthesis of 2 aberrant CDK13 transcripts in lymphoblastoid cells from an individual with a splice-site variant. Clinical characteristics of the individuals include mild to severe ID, developmental delay, behavioral problems, (neonatal) hypotonia and a variety of facial dysmorphism. Congenital heart defects were present in 2 individuals of the current cohort, but in at least 42% of all known individuals. An overview of all published cases is provided and does not demonstrate an obvious genotype-phenotype correlation, although 2 individuals harboring a stop codons at the end of the kinase domain might have a milder phenotype. Overall, there seems not to be a clinically recognizable facial appearance. The variability in the phenotypes impedes an à vue diagnosis of this syndrome and therefore genome-wide or gene-panel driven genetic testing is needed. Based on this overview, we provide suggestions for clinical work-up and management of this recently described ID syndrome.
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Affiliation(s)
- W M R van den Akker
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - I Brummelman
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - L M Martis
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - R N Timmermans
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - R Pfundt
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - T Kleefstra
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M H Willemsen
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - E H Gerkes
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J C Herkert
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - A J van Essen
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - P Rump
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - F Vansenne
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - P A Terhal
- Department of Genetics, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - M M van Haelst
- Department of Genetics, University Medical Centre Utrecht, Utrecht, The Netherlands.,Department of Clinical Genetics, AMC/VUmc, Amsterdam, The Netherlands
| | - I Cristian
- Division of Genetics and Metabolism, Department of Pediatrics, Nemours Children's Hospital Orlando, Orlando, Florida
| | - C E Turner
- Department of Genetics, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - M T Cho
- GeneDx, Gaithersburg, Maryland
| | | | | | - E Fassi
- Division of Genetics and Genomic Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
| | - K L I van Gassen
- Department of Genetics, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - A P A Stegmann
- Department of Human Genetics, Maastricht University Hospital, Maastricht, The Netherlands
| | - B B A de Vries
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
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Powis Z, Farwell Hagman K, Mroske C, McWalter K, Cohen J, Colombo R, Serretti A, Fatemi A, David K, Reynolds J, Immken L, Nagakura H, Cunniff C, Payne K, Barbaro-Dieber T, Gripp K, Baker L, Stamper T, Aleck K, Jordan E, Hersh J, Burton J, Wentzensen I, Guillen Sacoto M, Willaert R, Cho M, Petrik I, Huether R, Tang S. Expansion and further delineation of the SETD5
phenotype leading to global developmental delay, variable dysmorphic features, and reduced penetrance. Clin Genet 2018; 93:752-761. [DOI: 10.1111/cge.13132] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 08/30/2017] [Accepted: 09/04/2017] [Indexed: 01/23/2023]
Affiliation(s)
- Z. Powis
- Division of Emerging Genetics Medicine; Ambry Genetics; Aliso Viejo California
| | | | - C. Mroske
- Division of Clinical Genomics; Ambry Genetics; Aliso Viejo California
| | | | - J.S. Cohen
- Division of Neurogenetics, Hugo W. Moser Research Institute; Kennedy Krieger Institute; Baltimore Maryland
| | - R. Colombo
- Faculty of Medicine, Institute of Clinical Biochemistry; Catholic University and Policlinico Agostino Gemelli; Rome Italy
- Center for the Study of Rare Hereditary Disease; Niguarda Ca’ Granda Metropolitan Hospital; Milan Italy
| | - A. Serretti
- Department of Biomedical and NeuroMotor Sciences; University of Bologna; Bologna Italy
| | - A. Fatemi
- Division of Neurogenetics, Hugo W. Moser Research Institute; Kennedy Krieger Institute; Baltimore Maryland
- Department of Neurology and Pediatrics; The Johns Hopkins Hospital; Baltimore Maryland
| | - K.L. David
- Department of Medicine, Division of Genetics, New York Methodist Hospital; Brooklyn New York
| | - J. Reynolds
- Department of Medical Genetics, Shodair Children's Hospital; Helena Montana
| | - L. Immken
- Department of Genetics Specially for Children Genetics; Austin Texas
| | - H. Nagakura
- Department of Genetics Specially for Children Genetics; Austin Texas
| | - C.M. Cunniff
- Department of Pediatrics, Weill Cornell Medicine; New York New York
| | - K. Payne
- Child Neurology; Riley Hospital for Children; Indianapolis Indiana
| | - T. Barbaro-Dieber
- Department of Genetics, Cook Children's Medical Center; Fort Worth Texas
| | - K.W. Gripp
- Department of Genetics, Cook Children's Medical Center; Fort Worth Texas
| | - L. Baker
- Division of Medical Genetics; A.I. duPont Hospital for Children; Wilmington Delaware
| | - T. Stamper
- Department of Pediatrics, Section on Medical Genetics; Wake Forest Baptist Medical Center; Winston-Salem North Carolina
| | - K.A. Aleck
- Department of Genetics and Metabolism, Phoenix Children's Hospital; Phoenix Arizona
| | - E.S. Jordan
- Weisskopf Center, University of Louisville Clinical Genetics Unit; Louisville Kentucky
| | - J.H. Hersh
- Weisskopf Center, University of Louisville Clinical Genetics Unit; Louisville Kentucky
| | - J. Burton
- Department of Genetics, University of Illinois College of Medicine at Peoria; Peoria Illinois
| | | | | | | | | | - I. Petrik
- Division of Clinical Genomics; Ambry Genetics; Aliso Viejo California
| | - R. Huether
- Division of Clinical Genomics; Ambry Genetics; Aliso Viejo California
| | - S. Tang
- Division of Clinical Genomics; Ambry Genetics; Aliso Viejo California
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Deroo L, Vermeersch H, Willaert R, De Keyzer F, Vanneuville B, De Schryver I. Orbital lymphoma presenting as a recurrence of posterior scleritis after treatment with adalimumab. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0t078] [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: 11/26/2022]
Affiliation(s)
- L. Deroo
- Faculty of Medicine and Health Sciences; Ghent University; Gent Belgium
| | - H. Vermeersch
- Head- Neck and Maxillo-Facial Surgery; Ghent University Hospital; Ghent Belgium
| | - R. Willaert
- Head- Neck and Maxillo-Facial Surgery; Ghent University Hospital; Ghent Belgium
| | - F. De Keyzer
- Rheumatology; Ghent University Hospital; Ghent Belgium
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22
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Stern D, Cho MT, Chikarmane R, Willaert R, Retterer K, Kendall F, Deardorff M, Hopkins S, Bedoukian E, Slavotinek A, Schrier Vergano S, Spangler B, McDonald M, McConkie-Rosell A, Burton BK, Kim KH, Oundjian N, Kronn D, Chandy N, Baskin B, Guillen Sacoto MJ, Wentzensen IM, McLaughlin HM, McKnight D, Chung WK. Association of the missense variant p.Arg203Trp in PACS1 as a cause of intellectual disability and seizures. Clin Genet 2017; 92:221-223. [PMID: 28111752 DOI: 10.1111/cge.12956] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 12/05/2016] [Accepted: 12/06/2016] [Indexed: 02/04/2023]
Abstract
Graphical abstract key: ADHD, attention deficit hyperactivity disorder; ASD, atrial septal defect; DD, developmental delay; EEG, electroencephalogram; Ht, height; ID, intellectual disability; OCD, obsessive-compulsive disorder; OFC, open fontanelle; PDA, patent ductus arteriosis; PFO, patent foramen ovale; VSD, ventricular septal defect; Wt, weight.
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Affiliation(s)
- D Stern
- Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
| | - M T Cho
- GeneDx, Gaithersburg, MD, USA
| | | | | | | | - F Kendall
- VMP Genetics, Roswell, GA, USA.,Department of Kinesiology, University of Georgia, Athens, GA, USA
| | - M Deardorff
- Department of Pediatrics, Division of Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - S Hopkins
- Division of Neurology, The Children's Hospital of Philadelphia, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - E Bedoukian
- Individualized Medical Genetics Center, Division of Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - A Slavotinek
- Department of Pediatrics, UCSF Benioff Children's Hospital, University of California, San Francisco, CA, USA
| | - S Schrier Vergano
- Division of Medical Genetics and Metabolism, Children's Hospital of The King's Daughters, Norfolk, VA, USA
| | - B Spangler
- Division of Medical Genetics and Metabolism, Children's Hospital of The King's Daughters, Norfolk, VA, USA
| | - M McDonald
- Division of Medical Genetics, Duke University Medical Center, Durham, NC, USA
| | - A McConkie-Rosell
- Division of Medical Genetics, Duke University Medical Center, Durham, NC, USA
| | - B K Burton
- Division of Genetics, Birth Defects & Metabolism, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - K H Kim
- Division of Genetics, Birth Defects & Metabolism, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | | | - D Kronn
- New York Medical College, Valhalla, NY, USA
| | - N Chandy
- New York Medical College, Valhalla, NY, USA
| | | | | | | | | | | | - W K Chung
- Department of Pediatrics, Columbia University Medical Center, New York, NY, USA.,Department of Medicine, Columbia University Medical Center, New York, NY, USA
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Van Mulders SEB, Verbelen P, Willaert R, Delvaux FR. Adhesion of industrial brewer's yeasts: a new technique to improve continuous fermentation systems. Commun Agric Appl Biol Sci 2007; 72:313-317. [PMID: 18018909] [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] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- S E B Van Mulders
- Centre for Malting and Brewing Science (CMBS), Department of Microbial and Molecular Systems, K.U. Leuven, Kasteelpark Arenberg 22, BE-3001 Heverlee, Belgium
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Sleutel M, VandeWeerdt C, Maes D, Wyns L, Willaert R. Molecular resolution imaging of growing triosephosphate isomerase crystals. Acta Crystallogr A 2006. [DOI: 10.1107/s0108767306096735] [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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25
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Willaert R, Vanhee C, De Tandt C, Ranson W, Vounckx R, Wyns L. Design and construction of a microfluidic device for studying protein nucleation and crystallisation. Acta Crystallogr A 2006. [DOI: 10.1107/s0108767306097480] [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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26
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Blumenthal M, Miller M, Reilly C, Oetting W, Brott M, Willaert R, Luah S, King R. Analysis of ADORA3 as a possible candidate gene for asthma. J Allergy Clin Immunol 2005. [DOI: 10.1016/j.jaci.2004.12.883] [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: 10/25/2022]
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Abstract
A 'microscope reactor' was used to study on-line the dynamics of gel immobilized cell systems. The applicability of the reactor is demonstrated by a study of the growth kinetics of Saccharomyces cerevisiae entrapped in 2% calcium alginate. The specific growth rates of single immobilized cells and free cells were measured. The growth of a microcolony in Ca-alginate was followed and the specific growth rate of the cells in the microcolony determined. A simple growth model was used to estimate the cell volume fraction of the yeast cells in the microcolony. As internal and external mass transfer limitations can be neglected and immobilized cell growth rates were found to be identical to those of free cells, one may conclude that immobilization does not influence cell growth under our experimental conditions.
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Affiliation(s)
- R Willaert
- Department of Chemical Engineering, Vrije Universiteit Brussel, Belgium
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De Backer L, Devleminck S, Willaert R, Baron G. Reaction and diffusion in a gel membrane reactor containing immobilized cells. Biotechnol Bioeng 1992; 40:322-8. [DOI: 10.1002/bit.260400217] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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