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Yuan X, Liu B, Cuevas P, Brunski J, Aellos F, Petersen J, Koehne T, Bröer S, Grüber R, LeBlanc A, Zhang X, Xu Q, Helms J. Linking the Mechanics of Chewing to Biology of the Junctional Epithelium. J Dent Res 2023; 102:1252-1260. [PMID: 37555395 PMCID: PMC10626588 DOI: 10.1177/00220345231185288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Abstract
The capacity of a tissue to continuously alter its phenotype lies at the heart of how an animal is able to quickly adapt to changes in environmental stimuli. Within tissues, differentiated cells are rigid and play a limited role in adapting to new environments; however, differentiated cells are replenished by stem cells that are defined by their phenotypic plasticity. Here we demonstrate that a Wnt-responsive stem cell niche in the junctional epithelium is responsible for the capability of this tissue to quickly adapt to changes in the physical consistency of a diet. Mechanical input from chewing is required to both establish and maintain this niche. Since the junctional epithelium directly attaches to the tooth surface via hemidesmosomes, a soft diet requires minimal mastication, and consequently, lower distortional strains are produced in the tissue. This reduced strain state is accompanied by reduced mitotic activity in both stem cells and their progeny, leading to tissue atrophy. The atrophied junctional epithelium exhibits suboptimal barrier functions, allowing the ingression of bacteria into the underlying connective tissues, which in turn trigger inflammation and mild alveolar bone loss. These data link the mechanics of chewing to the biology of tooth-supporting tissues, revealing how a stem cell niche is responsible for the remarkable adaptability of the junctional epithelium to different diets.
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Affiliation(s)
- X. Yuan
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Department of Otolaryngology-Head & Neck Surgery, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - B. Liu
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - P. Cuevas
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - J. Brunski
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - F. Aellos
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - J. Petersen
- Department of Orthodontics, University of Leipzig Medical Center, Saxony, Germany
| | - T. Koehne
- Department of Orthodontics, University of Leipzig Medical Center, Saxony, Germany
| | - S. Bröer
- Institute of Pharmacology and Toxicology, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - R. Grüber
- Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - A. LeBlanc
- Centre for Oral, Clinical & Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, UK
| | - X. Zhang
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Q. Xu
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
- The Affiliated Hospital of Qingdao University, College of Stomatology, Qingdao University, Qingdao, China
| | - J.A. Helms
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
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2
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Chen J, Cuevas P, Dworan J, Dawid I, Turkkahraman H, Tran K, Delgado-Calle J, Bellido T, Gorski J, Liu B, Brunski J, Helms J. Wnt/β-catenin Signaling Controls Maxillofacial Hyperostosis. J Dent Res 2022; 101:793-801. [PMID: 35114849 PMCID: PMC10850863 DOI: 10.1177/00220345211067705] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The roles of Wnt/β-catenin signaling in regulating the morphology and microstructure of craniomaxillofacial (CMF) bones was explored using mice carrying a constitutively active form of β-catenin in activating Dmp1-expressing cells (e.g., daβcatOt mice). By postnatal day 24, daβcatOt mice exhibited midfacial truncations coupled with maxillary and mandibular hyperostosis that progressively worsened with age. Mechanistic insights into the basis for the hyperostotic facial phenotype were gained through molecular and cellular analyses, which revealed that constitutively activated β-catenin in Dmp1-expressing cells resulted in an increase in osteoblast number and an increased rate of mineral apposition. An increase in osteoblasts was accompanied by an increase in osteocytes, but they failed to mature. The resulting CMF bone matrix also had an abundance of osteoid, and in locations where compact lamellar bone typically forms, it was replaced by porous, woven bone. The hyperostotic facial phenotype was progressive. These findings identify for the first time a ligand-independent positive feedback loop whereby unrestrained Wnt/β-catenin signaling results in a CMF phenotype of progressive hyperostosis combined with architecturally abnormal, poorly mineralized matrix that is reminiscent of craniotubular disorders in humans.
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Affiliation(s)
- J. Chen
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Palo Alto, CA, USA
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - P.L. Cuevas
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Palo Alto, CA, USA
| | - J.S. Dworan
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Palo Alto, CA, USA
- Medical University of Vienna, Department of Anatomy, Center for Anatomy and Cell Biology, Vienna, Austria
| | - I. Dawid
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Palo Alto, CA, USA
| | - H. Turkkahraman
- Indiana University School of Dentistry, Department of Orthodontics & Oral Facial Genetics, Indianapolis, IN, USA
| | - K. Tran
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Palo Alto, CA, USA
| | - J. Delgado-Calle
- Department of Physiology & Biophysics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - T. Bellido
- Department of Physiology & Biophysics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - J.P. Gorski
- Department of Oral and Craniofacial Sciences, School of Dentistry, and Center of Excellence in Mineralized Tissue Research, University of Missouri–Kansas City, Kansas City, MO, USA
| | - B. Liu
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Palo Alto, CA, USA
| | - J.B. Brunski
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Palo Alto, CA, USA
| | - J.A. Helms
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Palo Alto, CA, USA
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Merdji H, Mayeur S, Schenck M, Oulehri W, Clere-Jehl R, Cunat S, Herbrecht JE, Janssen-Langenstein R, Nicolae A, Helms J, Meziani F, Chenard MP. Histopathological features in fatal COVID-19 acute respiratory distress syndrome. Med Intensiva 2021; 45:261-270. [PMID: 34059216 PMCID: PMC8161799 DOI: 10.1016/j.medine.2021.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 02/05/2021] [Indexed: 12/15/2022]
Abstract
Background COVID-19 acute respiratory distress syndrome (ARDS) shares the common histological hallmarks with other forms of ARDS. However, the chronology of the histological lesions has not been well established. Objective To describe the chronological histopathological alterations in the lungs of patients with COVID-19 related ARDS. Design A prospective cohort study was carried out. Setting Intensive Care Unit of a tertiary hospital. Patients The first 22 consecutive COVID-19 deaths. Measurements Lung biopsies and histopathological analyses were performed in deceased patients with COVID-19 related ARDS. Clinical data and patient course were evaluated. Results The median patient age was 66 [63–74] years; 73% were males. The median duration of mechanical ventilation was 17 [8–24] days. COVID-19 induced pulmonary injury was characterized by an exudative phase in the first week of the disease, followed by a proliferative/organizing phase in the second and third weeks, and finally an end-stage fibrosis phase after the third week. Viral RNA and proteins were detected in pneumocytes and macrophages in a very early stage of the disease, and were no longer detected after the second week. Limitation Limited sample size. Conclusions The chronological evolution of COVID-19 lung histopathological lesions seems to be similar to that seen in other forms of ARDS. In particular, lung lesions consistent with potentially corticosteroid-sensitive lesions are seen.
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Affiliation(s)
- H Merdji
- Service de Médecine Intensive - Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France
| | - S Mayeur
- Département de Pathologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - M Schenck
- Service de Médecine Intensive - Réanimation, Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - W Oulehri
- Service d'Anesthésie - Réanimation Chirurgicale, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France
| | - R Clere-Jehl
- Service de Médecine Intensive - Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France
| | - S Cunat
- Service de Médecine Intensive - Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - J-E Herbrecht
- Service de Médecine Intensive - Réanimation, Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - R Janssen-Langenstein
- Service de Médecine Intensive - Réanimation, Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - A Nicolae
- Département de Pathologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - J Helms
- Service de Médecine Intensive - Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France
| | - F Meziani
- Service de Médecine Intensive - Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France.
| | - M-P Chenard
- Département de Pathologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Centre de Ressources biologiques, Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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4
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Taghboulit N, Voiriot G, Demoule A, Helms J. Infections sévères à SARS-CoV-2. Revue des Maladies Respiratoires Actualités 2021; 13:1S68-1S71. [PMID: 34188724 PMCID: PMC8227341 DOI: 10.1016/s1877-1203(21)00060-4] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- N. Taghboulit
- Service de pneumologie, CHU Amiens-Picardie, Amiens, France
- Auteur correspondant. Adresse e-mail : (N. Taghboulit)
| | - G. Voiriot
- Service de pneumologie, CHU Amiens-Picardie, Amiens, France
| | - A. Demoule
- Service de pneumologie, CHU Amiens-Picardie, Amiens, France
| | - J. Helms
- Service de pneumologie, CHU Amiens-Picardie, Amiens, France
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5
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Merdji H, Mayeur S, Schenck M, Oulehri W, Clere-Jehl R, Cunat S, Herbrecht JE, Janssen-Langenstein R, Nicolae A, Helms J, Meziani F, Chenard MP. Histopathological features in fatal COVID-19 acute respiratory distress syndrome. Med Intensiva 2021; 45:261-270. [PMID: 34054173 PMCID: PMC7914021 DOI: 10.1016/j.medin.2021.02.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 02/05/2021] [Indexed: 12/15/2022]
Abstract
Background COVID-19 acute respiratory distress syndrome (ARDS) shares the common histological hallmarks with other forms of ARDS. However, the chronology of the histological lesions has not been well established. Objective To describe the chronological histopathological alterations in the lungs of patients with COVID-19 related ARDS. Design A prospective cohort study was carried out. Setting Intensive Care Unit of a tertiary hospital. Patients The first 22 consecutive COVID-19 deaths. Measurements Lung biopsies and histopathological analyses were performed in deceased patients with COVID-19 related ARDS. Clinical data and patient course were evaluated. Results The median patient age was 66 [63–74] years; 73% were males. The median duration of mechanical ventilation was 17 [8–24] days. COVID-19 induced pulmonary injury was characterized by an exudative phase in the first week of the disease, followed by a proliferative/organizing phase in the second and third weeks, and finally an end-stage fibrosis phase after the third week. Viral RNA and proteins were detected in pneumocytes and macrophages in a very early stage of the disease, and were no longer detected after the second week. Limitation Limited sample size. Conclusions The chronological evolution of COVID-19 lung histopathological lesions seems to be similar to that seen in other forms of ARDS. In particular, lung lesions consistent with potentially corticosteroid-sensitive lesions are seen.
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Key Words
- ACE2, angiotensin-converting enzyme 2
- AFOP, acute fibrinous and organizing pneumonia
- ARDS, acute respiratory distress syndrome
- COVID-19
- COVID-19 related acute respiratory distress syndrome
- COVID-19, coronavirus infectious disease
- DAD, diffuse alveolar damage
- HE, hematoxylin–eosin
- Histopathology
- ISH, in situ hybridization
- NMBD, neuromuscular blocking drugs
- RT-PCR, Reverse Transcriptase-Polymerase chain reaction
- SAPSII, simplified acute physiology score
- SARS-CoV-2
- SOFA, Sequential Organ Failure Assessment
- VILI, ventilator induced lung injury
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Affiliation(s)
- H Merdji
- Service de Médecine Intensive - Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France
| | - S Mayeur
- Département de Pathologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - M Schenck
- Service de Médecine Intensive - Réanimation, Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - W Oulehri
- Service d'Anesthésie - Réanimation Chirurgicale, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France
| | - R Clere-Jehl
- Service de Médecine Intensive - Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France
| | - S Cunat
- Service de Médecine Intensive - Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - J-E Herbrecht
- Service de Médecine Intensive - Réanimation, Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - R Janssen-Langenstein
- Service de Médecine Intensive - Réanimation, Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - A Nicolae
- Département de Pathologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - J Helms
- Service de Médecine Intensive - Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France
| | - F Meziani
- Service de Médecine Intensive - Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France
| | - M-P Chenard
- Département de Pathologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,Centre de Ressources biologiques, Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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6
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Clere-Jehl R, Merdji H, Derhy D, Helms J. Blindness as an uncommon complication of Streptococcus pneumoniae systemic infection. Intensive Care Med 2018; 45:263-265. [DOI: 10.1007/s00134-018-5486-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 11/28/2018] [Indexed: 10/27/2022]
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7
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Merdji H, Clere-Jehl R, Dargent A, Andreu P, Large A, Lefebvre F, Schenck M, Helms J, Quenot JP, Meziani F. Out of the ICU shifting as a significant workload. Intensive Care Med 2018; 44:1582-1583. [PMID: 29947882 DOI: 10.1007/s00134-018-5240-7] [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] [Received: 05/08/2018] [Accepted: 05/21/2018] [Indexed: 10/14/2022]
Affiliation(s)
- H Merdji
- Faculté de Médecine, Hôpitaux Universitaires de Strasbourg, Service de Réanimation, Université de Strasbourg (UNISTRA), Nouvel Hôpital Civil 1, Place de l'Hôpital, 67091, Strasbourg Cedex, France.,INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France
| | - R Clere-Jehl
- Faculté de Médecine, Hôpitaux Universitaires de Strasbourg, Service de Réanimation, Université de Strasbourg (UNISTRA), Nouvel Hôpital Civil 1, Place de l'Hôpital, 67091, Strasbourg Cedex, France
| | - A Dargent
- Department of Intensive Care, François Mitterrand University Hospital, Dijon, France.,Lipnes Team, INSERM Research Center LNC-UMR 1231 and LabExLipSTIC, Dijon, France
| | - P Andreu
- Department of Intensive Care, François Mitterrand University Hospital, Dijon, France
| | - A Large
- Department of Intensive Care, François Mitterrand University Hospital, Dijon, France
| | - F Lefebvre
- Department of Public Health, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - M Schenck
- Faculté de Médecine, Hôpitaux Universitaires de Strasbourg, Service de Réanimation, Hôpital de Hautepierre, Université de Strasbourg (UNISTRA), Strasbourg, France
| | - J Helms
- Faculté de Médecine, Hôpitaux Universitaires de Strasbourg, Service de Réanimation, Université de Strasbourg (UNISTRA), Nouvel Hôpital Civil 1, Place de l'Hôpital, 67091, Strasbourg Cedex, France
| | - J P Quenot
- Department of Intensive Care, François Mitterrand University Hospital, Dijon, France.,Lipnes Team, INSERM Research Center LNC-UMR 1231 and LabExLipSTIC, Dijon, France.,INSERM CIC 1432, Clinical Epidemiology, University of Burgundy, Dijon, France
| | - F Meziani
- Faculté de Médecine, Hôpitaux Universitaires de Strasbourg, Service de Réanimation, Université de Strasbourg (UNISTRA), Nouvel Hôpital Civil 1, Place de l'Hôpital, 67091, Strasbourg Cedex, France. .,INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France.
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Chen CH, Pei X, Tulu U, Aghvami M, Chen CT, Gaudillière D, Arioka M, Maghazeh Moghim M, Bahat O, Kolinski M, Crosby T, Felderhoff A, Brunski J, Helms J. A Comparative Assessment of Implant Site Viability in Humans and Rats. J Dent Res 2018; 97:451-459. [PMID: 29202640 PMCID: PMC5863872 DOI: 10.1177/0022034517742631] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Our long-term objective is to devise methods to improve osteotomy site preparation and, in doing so, facilitate implant osseointegration. As a first step in this process, we developed a standardized oral osteotomy model in ovariectomized rats. There were 2 unique features to this model: first, the rats exhibited an osteopenic phenotype, reminiscent of the bone health that has been reported for the average dental implant patient population. Second, osteotomies were produced in healed tooth extraction sites and therefore represented the placement of most implants in patients. Commercially available drills were then used to produce osteotomies in a patient cohort and in the rat model. Molecular, cellular, and histologic analyses demonstrated a close alignment between the responses of human and rodent alveolar bone to osteotomy site preparation. Most notably in both patients and rats, all drilling tools created a zone of dead and dying osteocytes around the osteotomy. In rat tissues, which could be collected at multiple time points after osteotomy, the fate of the dead alveolar bone was followed. Over the course of a week, osteoclast activity was responsible for resorbing the necrotic bone, which in turn stimulated the deposition of a new bone matrix by osteoblasts. Collectively, these analyses support the use of an ovariectomy surgery rat model to gain insights into the response of human bone to osteotomy site preparation. The data also suggest that reducing the zone of osteocyte death will improve osteotomy site viability, leading to faster new bone formation around implants.
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Affiliation(s)
- C.-H. Chen
- Craniofacial Research Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University School of Medicine, Taoyuan, Taiwan
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - X. Pei
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - U.S. Tulu
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - M. Aghvami
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - C.-T. Chen
- Craniofacial Research Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University School of Medicine, Taoyuan, Taiwan
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - D. Gaudillière
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - M. Arioka
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Department of Clinical Pharmacology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - M. Maghazeh Moghim
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
- University College London Medical School, University College London, London, UK
| | - O. Bahat
- Private practice, Beverly Hills, CA, USA
| | | | | | | | - J.B. Brunski
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - J.A. Helms
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
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10
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Huang L, Liu B, Cha J, Yuan G, Kelly M, Singh G, Hyman S, Brunski J, Li J, Helms J. Mechanoresponsive Properties of the Periodontal Ligament. J Dent Res 2016; 95:467-75. [PMID: 26767771 DOI: 10.1177/0022034515626102] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The periodontal ligament (PDL) functions as an enthesis, a connective tissue attachment that dissipates strains created by mechanical loading. Entheses are mechanoresponsive structures that rapidly adapt to changes in their mechanical loading; here we asked which features of the PDL are sensitive to such in vivo loading. We evaluated the PDL in 4 physiologically relevant mechanical environments, focusing on mitotic activity, cell density, collagen content, osteogenic protein expression, and organization of the tissue. In addition to examining PDLs that supported teeth under masticatory loading and eruptive forces, 2 additional mechanical conditions were created and analyzed: hypoloading and experimental tooth movement. Collectively, these data revealed that the adult PDL is a remarkably quiescent tissue and that only when it is subjected to increased loads—such as those associated with mastication, eruption, and orthodontic tooth movement—does the tissue increase its rate of cell proliferation and collagen production. These data have relevance in clinical scenarios where PDL acclimatization can be exploited to optimize tooth movement.
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Affiliation(s)
- L. Huang
- Orthodontic Department, Stomatology Hospital of Chongqing Medical University; Chongqing Key Laboratory of Oral Disease and Biomedical Sciences; Chongqing Municipal Key Laboratory, Chongqing, China
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, CA, USA
| | - B. Liu
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, CA, USA
| | - J.Y. Cha
- Department of Orthodontics, College of Dentistry, Yonsei University, Seoul, South Korea
| | - G. Yuan
- Department of Orthodontics, Dalian Stomatological Hospital, Dalian Medical University, Dalian, China
| | - M. Kelly
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, CA, USA
| | - G. Singh
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, CA, USA
| | - S. Hyman
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, CA, USA
| | - J.B. Brunski
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, CA, USA
| | - J. Li
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, CA, USA
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - J.A. Helms
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, CA, USA
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Grehn S, Helms J. Acoustic neuromas presenting with symptoms of morbus Menière. Adv Otorhinolaryngol 2015; 24:94-9. [PMID: 629174 DOI: 10.1159/000400898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
If a patient with Menière's disease or a sudden deafness does not respond to adequate therapy, an acoustic neuroma should be excluded. This is achieved by a positive contrast cisternography using multidirectional tomography. The examples might have shown that sometimes acoustic neuromas present with atypical symptoms, with sudden deafness or even with the typical symptoms of morbus menière.
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Affiliation(s)
- J Helms
- Department of Otorhinolaryngology, University of Würzburg, FRG
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Mouraret S, Hunter D, Bardet C, Brunski J, Bouchard P, Helms J. A pre-clinical murine model of oral implant osseointegration. Bone 2014; 58:177-84. [PMID: 23886841 PMCID: PMC4962868 DOI: 10.1016/j.bone.2013.07.021] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 05/31/2013] [Accepted: 07/10/2013] [Indexed: 10/26/2022]
Abstract
Many of our assumptions concerning oral implant osseointegration are extrapolated from experimental models studying skeletal tissue repair in long bones. This disconnect between clinical practice and experimental research hampers our understanding of bone formation around oral implants and how this process can be improved. We postulated that oral implant osseointegration would be fundamentally equivalent to implant osseointegration elsewhere in the body. Mice underwent implant placement in the edentulous ridge anterior to the first molar and peri-implant tissues were evaluated at various timepoints after surgery. Our hypothesis was disproven; oral implant osseointegration is substantially different from osseointegration in long bones. For example, in the maxilla peri-implant pre-osteoblasts are derived from cranial neural crest whereas in the tibia peri-implant osteoblasts are derived from mesoderm. In the maxilla, new osteoid arises from periostea of the maxillary bone but in the tibia the new osteoid arises from the marrow space. Cellular and molecular analyses indicate that osteoblast activity and mineralization proceeds from the surfaces of the native bone and osteoclastic activity is responsible for extensive remodeling of the new peri-implant bone. In addition to histologic features of implant osseointegration, molecular and cellular assays conducted in a murine model provide new insights into the sequelae of implant placement and the process by which bone is generated around implants.
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Affiliation(s)
- S. Mouraret
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, CA 94305, USA
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, Paris 7 Denis, Diderot University, U.F.R. of Odontology, Paris, France
| | - D.J. Hunter
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, CA 94305, USA
| | - C. Bardet
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, CA 94305, USA
- Dental School University Paris Descartes PRES Sorbonne Paris Cité, EA 2496 Montrouge, France
| | - J.B. Brunski
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, CA 94305, USA
| | - P. Bouchard
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, Paris 7 Denis, Diderot University, U.F.R. of Odontology, Paris, France
| | - J.A. Helms
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, CA 94305, USA
- Corresponding author. Fax: +1 650 736 4374. (J.A. Helms)
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Wang Z, Tran M, Barbhaiya N, Jang K, Rashidi V, La Russa M, Choo K, Fattakhov E, Kundu R, Quertermous T, Longaker M, Helms J, Yang G. DEL1 Protects Against Osteoarthritis by Preventing Chondrocyte Apoptosis. J Surg Res 2012. [DOI: 10.1016/j.jss.2011.11.224] [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: 11/30/2022]
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Abstract
A T shaped cartilage, placed into the open oval window, functions as a stapes. The transvers part of the T prevents a too deep insertion into the vestibule. If necessary small stripes of connective tissue seal the vestibule.
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Affiliation(s)
- J Helms
- Universität Würzburg Universitäts-HNO-Klinik, Germany.
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Helms J, Moser L. Qualität des Hörens und der Kommunikation mit unterschiedlichen Cochlea-Implantaten. Laryngorhinootologie 2010; 89:660-1. [DOI: 10.1055/s-0030-1254127] [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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Radeloff A, Hamad M, Baier G, Helms J, Hagen R, Shehata-Dieler W. [Short and long term results of endolymphatic sac surgery: a patient-questionnaire based study]. Laryngorhinootologie 2009; 88:653-9. [PMID: 19562654 DOI: 10.1055/s-0029-1224113] [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: 10/20/2022]
Abstract
INTRODUCTION The endolymphatic sac surgery for the treatment of Meniere's disease has been described since the 1920s. The success rate of this technique in terms of vertigo control has been reported to be 50-80%. However, the value of this treatment method remained controversial. Furthermore, the reliable identification of the endolymphatic sac intraoperatively can be challenging in some cases. This study examines the short-, middle- and long-term results in a larger cohort of patients. MATERIALS AND METHODS In 74 patients, vertigo control, tinnitus and degree of satisfaction was evaluated by means of a questionnaire retrospectively. Additionally, the diagnostic value of the electrocochleography (EcochG) was determined. RESULTS The overall vertigo control rate was more than 70% in patients followed up for two years and has reached 81% in patients followed up for more than two years. Hearing preservation rate was 61%. Tinnitus has disappeared in 11% and improved in 23% of the patients. In 47% of the patients it was unchanged and in 19% worsened. The difference in EcochG results pre- versus postoperative was highly significant. CONCLUSIONS ELSS is a useful tool in the management of Ménière's disease, in particular in patients that do not benefit sufficiently from conservative therapy.
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Affiliation(s)
- A Radeloff
- Klinik für Hals-Nasen-Ohrenheilkunde, plastische und ästhetische Operationen der Julius-Maximilians-Universität Würzburg
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Chen J, Zhao B, Longaker M, Helms J, Carter D. Periosteal biaxial residual strains correlate with bone specific growth rates in chick embryos. Comput Methods Biomech Biomed Engin 2008; 11:453-61. [DOI: 10.1080/10255840802129817] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Baier G, Schwager K, Helms J, Hagen R. [Results in otosurgically treated patients with acoustic neuroma. Part 1: Facial nerve function after translabyrinthine and middle fossa resection]. Laryngorhinootologie 2008; 87:565-72. [PMID: 18421647 DOI: 10.1055/s-2007-995644] [Citation(s) in RCA: 11] [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] [Indexed: 10/21/2022]
Abstract
BACKGROUND Regardless of all efforts to preserve a residual hearing, facial nerve function is still the primary issue for patients with acoustic neuromas. Since alternative methods like the gamma-knife treatment are of increasing importance, results after surgery have to be compared and discussed critically. PATIENTS The results of 538 patients operated at the Dept. of Otolaryngology, Head and Neck Surgery, University of Wuerzburg between 1989 and 2004 are presented. 392 had surgery via a middle fossa, 146 via a translabyrinthine approach. RESULTS Shortly after surgery 82.2 % of patients showed no facial palsy. 74 patients had an incomplete, 7 a complete paresis. After 12 months 144 of the patients operated on via middle fossa approach showed no palsy, 13 had an incomplete and one a complete paresis. Out of 76 patients operated on translabyrinthine approach 75 had no paresis, one had an incomplete, and no patient had a complete paresis. There was no difference between intrameatal tumors and tumors extending beyond the porus. Regular facial nerve function was seen in 93 %, postoperatively. Permanent paresis was seen in 0.4 % of cases. CONCLUSION Acoustic neuroma confined to the internal meatus or with minor extension into the cerebello-pontine angle (i. e. no contact to structures of the brain stem or vessels of the posterior fossa) are feasible for resection via a middle fossa or translabyrinthine approach. The possibility of hearing preservation combined with low morbidity and good results of facial nerve function makes these approaches the treatment of choice for this group of tumors.
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Affiliation(s)
- G Baier
- Klinik für HNO-Heilkunde, Kopf-, Hals- und Plastische Gesichtschirurgie, Klinikum Darmstadt, Darmstadt.
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Brugmann S, Helms J. Shaping up and shipping out: the role of cilia in growth and patterning. J Musculoskelet Neuronal Interact 2007; 7:300. [PMID: 18094481] [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 Brugmann
- Stanford University, Stanford, CA 94305, USA
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Baier G, Schwager K, Helms J, Hagen R. Hörresultate und Fazialisfunktion bei otochirurgisch operierten Patienten mit Akustikusneurinom. Skull Base 2007. [DOI: 10.1055/s-2006-957239] [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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Shehata-Dieler W, Völter C, Hildmann A, Hildmann H, Helms J. Klinische und audiologische Befunde von Kindern mit auditorischer Neuropathie und ihre Versorgung mit einem Cochlea-Implantat. Laryngorhinootologie 2007; 86:15-21. [PMID: 17283495 DOI: 10.1055/s-2006-925369] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Auditory neuropathy is a disorder characterised by preservation of outer hair cells function with normal otoacoustic emissions (OAEs), but with absent auditory brainstem responses (ABR). Perisynaptic synchronisation disorder is one of the possible pathogenesis underlying auditory neuropathy. In this paper we describe the clinical presentation and audiological findings in pediatric auditory neuropathy and its management. PATIENTS AND METHODS 9 children with auditory neuropathy could be included in the study. An audiological evaluation was performed in all children including behavioural audiometry, measurement of the OAEs as well as electrocochleography (ECoG) and ABR recordings. Children who failed to get any benefit from conventional amplification received a cochlear implant. Prior to implantation the responses to electrical stimuli were examined with the promontory test and with the electrically evoked ABR. RESULTS One child showed auditory neuropathy only on one side with normal hearing thresholds on the contralateral ear. Another child had normal hearing thresholds after the follow up period. Four children received a hearing aid. But variable hearing reactions were observed. Thus in three cases a CI is planned. In three children cochlea implantation was done. Following implantation a remarkable improvement in hearing/speech capabilities with the CI compared to conventional hearing aids were observed in all three cases. Beside, these three children developed open set speech discrimination and are using now oral language for communication. CONCLUSIONS Auditory neuropathy is a disorder which presents with different clinical and audiological findings. Thus the management of this disorder must be an individual one. In light of our findings we support the use of cochlear implants as an option for children with auditory neuropathy in cases where conventional amplification does not work sufficiently.
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MESH Headings
- Audiometry, Evoked Response
- Audiometry, Speech
- Auditory Threshold/physiology
- Brain Stem/physiopathology
- Child, Preschool
- Cochlear Implantation
- Cochlear Nerve/physiopathology
- Evoked Potentials, Auditory, Brain Stem/physiology
- Female
- Follow-Up Studies
- Hair Cells, Auditory, Outer/physiopathology
- Hearing Loss, Sensorineural/diagnosis
- Hearing Loss, Sensorineural/physiopathology
- Hearing Loss, Sensorineural/rehabilitation
- Humans
- Infant
- Infant, Newborn
- Male
- Otoacoustic Emissions, Spontaneous/physiology
- Speech Discrimination Tests
- Vestibulocochlear Nerve Diseases/diagnosis
- Vestibulocochlear Nerve Diseases/physiopathology
- Vestibulocochlear Nerve Diseases/rehabilitation
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Affiliation(s)
- W Shehata-Dieler
- Universitätsklinikum Würzburg, Klinik und Poliklinik für Hals-, Nasen- und Ohrenkranke, Würzburg.
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Colnot C, Huang S, Helms J. Analyzing the cellular contribution of bone marrow to fracture healing using bone marrow transplantation in mice. Biochem Biophys Res Commun 2006; 350:557-61. [PMID: 17022937 DOI: 10.1016/j.bbrc.2006.09.079] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2006] [Accepted: 09/17/2006] [Indexed: 11/30/2022]
Abstract
The bone marrow is believed to play important roles during fracture healing such as providing progenitor cells for inflammation, matrix remodeling, and cartilage and bone formation. Given the complex nature of bone repair, it remains difficult to distinguish the contributions of various cell types. Here we describe a mouse model based on bone marrow transplantation and genetic labeling to track cells originating from bone marrow during fracture healing. Following lethal irradiation and engraftment of bone marrow expressing the LacZ transgene constitutively, wild type mice underwent tibial fracture. Donor bone marrow-derived cells, which originated from the hematopoietic compartment, did not participate in the chondrogenic and osteogenic lineages during fracture healing. Instead, the donor bone marrow contributed to inflammatory and bone resorbing cells. This model can be exploited in the future to investigate the role of inflammation and matrix remodeling during bone repair, independent from osteogenesis and chondrogenesis.
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Affiliation(s)
- C Colnot
- University of California at San Francisco, Department of Orthopaedic Surgery, San Francisco General Hospital, San Francisco, CA 94110, USA.
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Kaufmann W, Nevis K, Qu P, Ibrahim J, Zhou T, Zhou Y, Simpson D, Helms J, Cordeiro-Stone M, Sharpless N. Defective cell cycle checkpoint response to DNA double strand breaks is associated with altered patterns of gene expression. Melanoma Res 2006. [DOI: 10.1097/00008390-200609001-00008] [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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Brunski J, Currey J, Helms J, Leucht P, Nanci A, Nicolella D, Wazen R. Mechanobiology at healing bone-implant interfaces: strain distribution and tissue response. J Biomech 2006. [DOI: 10.1016/s0021-9290(06)83725-5] [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: 10/24/2022]
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Helms J. Laudatio für Herrn Prof. Dr. med. Wolfgang Draf. Laryngorhinootologie 2005. [DOI: 10.1055/s-2005-870560] [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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Völter C, Shehata-Dieler W, Baumann R, Helms J. [Development of a new test for speech audiometry in children and results in CI children]. Laryngorhinootologie 2005; 84:738-43. [PMID: 16231241 DOI: 10.1055/s-2005-861375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 10/25/2022]
Abstract
BACKGROUND Speech audiometry plays an important role for hearing evaluation in children. Hearing impaired children, such as those with cochlear implant (CI) who frequently undergo testing, learn the test words by heart. Furthermore, the standard tests use words of former time. PATIENTS AND METHODS Using the most frequently words of modern children's literature a speech assessment test was developed for children between 1 to 8 years. The material was first evaluated on normal hearing children. In a second step the phoneme and word perception scores of 35 CI children were measured using 60 - 100 dB SPL according to the most comfortable level (MCL) in free sound field. RESULTS The performance-intensity function for the single words were highly comparable with those of the Freiburger or Göttinger speech perception test. The average speech reception threshold in CI children was 44 % (test I), 36 % (test II), 63 % (test III) and 69 % (test IV), respectively. Compared to the Mainzer and Göttinger speech perception test the new words were more difficult to understand than those of the known tests. However, a statistically significant difference could be noted only for test II. CONCLUSIONS The new developed "Würzburger speech perception test" appears to be a useful additional tool for the evaluation of hearing impaired children in addition to the standard test procedures.
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Affiliation(s)
- C Völter
- Bayerische Julius-Maximilians-Universität, Klinik und Poliklinik für Hals-, Nasen- und Ohrenkranke, Würzburg.
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Schwager K, Pérez J, Klingelhöffer G, Baier G, Woydt M, Meinhardt M, Schweitzer T, Mlynski R, Roosen K, Helms J. Acoustic Neuroma Surgery—Interdisciplinary Assessment and Therapy. Skull Base 2005. [DOI: 10.1055/s-2005-916636] [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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Müller J, Helms J. [Cochlear implantation with preservation of residual deep frequency hearing]. HNO 2005; 53:753-5. [PMID: 16132875 DOI: 10.1007/s00106-005-1320-4] [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: 11/26/2022]
Affiliation(s)
- J Müller
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkranke der Universität Würzburg.
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Schoen F, Mueller J, Helms J, Nopp P. Sound localization and sensitivity to interaural cues in bilateral users of the Med-El Combi 40/40+cochlear implant system. Otol Neurotol 2005; 26:429-37. [PMID: 15891645 DOI: 10.1097/01.mao.0000169772.16045.86] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.4] [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: 11/25/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate sound localization in subjects bilaterally implanted with MED-EL COMBI 40/40+ cochlear implants. In addition, the sensitivity to interaural cues was assessed. METHODS In the localization test (11 subjects), CCITT noise (500 ms, original and HRTF-filtered, 70/75/80 dB sound pressure level) was presented from one of seven loudspeakers between -90 degrees and 90 degrees azimuth. The subject had to indicate which loudspeaker the noise was presented from. Sensitivity to interaural level differences (ILD) was assessed by performing localization tests (4 subjects) with the loudness of the two speech processors unbalanced to various degrees. To investigate the subjects' sensitivity to interaural time differences (ITD), lateralization was measured (7 subjects) as a function of the time difference between two Gaussian-like pulses, each directed to one of the subject's speech processor microphones by way of headphones. RESULTS The judgments of all subjects significantly correlated with the positions of the loudspeakers. The scatter in the judged azimuth measured by the standard deviation of the responses was on average 27.5 degrees . Unbalanced loudness of the speech processors produced a bias in azimuth toward the speech processor with the louder volume setting. The mean rate of shift was 1.4 degrees per unit on the Wuerzburg loudness scale. Six of seven subjects showed a significant sensitivity to ITDs with the approximate time difference required for complete lateralization being 1,200 micros on an average. The one subject not showing a sensitivity to ITDs performed worst in the localization test. CONCLUSIONS Bilateral cochlear implantation can restore spatial hearing in cochlear implant users. Both ILDs and ITDs are used by bilateral cochlear implant users in sound localization with ILDs appearing to be the dominant cue.
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Affiliation(s)
- F Schoen
- ENT Clinic, University of Wuerzburg, Wuerzburg, Germany.
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Helms J, Müller J, Brill S, Schön S, Shehata-Dieler W. Modern cochlear implantation. Otolaryngol Pol 2005; 59:803-5. [PMID: 16521441] [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: 05/07/2023]
Affiliation(s)
- J Helms
- Klinik und Poliklinik Fur Hals, Nasen- und Ohrenkranke Der Universitat Wurzburg, Wurzburg
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Helms J. Obituary of Professor Dr. Ernst Kastenbauer. Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-826121] [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: 10/26/2022]
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Kühn-Inacker H, Shehata-Dieler W, Müller J, Helms J. Bilateral cochlear implants: a way to optimize auditory perception abilities in deaf children? Int J Pediatr Otorhinolaryngol 2004; 68:1257-66. [PMID: 15364496 DOI: 10.1016/j.ijporl.2004.04.029] [Citation(s) in RCA: 113] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2003] [Revised: 04/23/2004] [Accepted: 04/27/2004] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The Würzburg bilateral cochlear implant (CI) program was started with the aim to improve the patients' communicative abilities in complex listening situations. In this study, the auditory skills of children using bilateral cochlear implants were evaluated. STUDY DESIGN AND SETTINGS Qualitative data based on free observations in the rehabilitation setup were collected in 39 bilaterally implanted children. A speech discrimination in noise test was performed in 18 of these children; lists of bisyllabic words were presented in noise at a signal to noise ratio (SNR) of +15 dB. RESULTS Qualitative and quantitative data show clearly that bilateral CI improves the children's communicative behaviour, especially in complex listening situations. Children examined with the speech in noise test scored significantly better under the bilateral condition compared to the unilateral condition. Integration of the second implanted side and use of binaural information was observed to be easier and faster in children with a short time lag between both implants. CONCLUSIONS To be able to obtain optimal benefit from bilateral cochlear implants, an intensive rehabilitation program is necessary. The important aspects of such a program are creating realistic expectations in older children before implantation; performing the first processor fitting of the second side with the first side switched on; and separate intensive training with the new system in order to balance out the hearing competence of the second CI with that of the first.
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Mlynski R, Brunner K, Brors D, Aletsee C, Dazert S, Helms J. Ätiologie, Diagnostik und Therapie von Exostosen des äußeren Gehörganges. Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-823423] [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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Mueller J, Schön F, Shehata-Dieler W, May B, Helms J. Ergebnisse nach bilateraler Cochlear Implant Versorgung bei Kindern und Erwachsenen. Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-823232] [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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Scheich M, Müller J, Helms J. CI in örtlicher Betäubung: Indikationen, Möglichkeiten, Grenzen. Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-823236] [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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Shehata-Dieler WE, Hildmann A, Hildmann H, Helms J. Klinsche und audiologische Befunde bei Kindern mit auditorischer Neuropathie vor und nach Versorgung mit einem Cochlear Implant. Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-823238] [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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Scholtz LU, Schneider D, Müller J, Helms J. Ergebnisse der Vestibularisdiagnostik bei Patienten nach Cochlear Implantation. Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-823237] [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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Schwager K, Klingelhöffer G, Hoppe F, Woydt M, Pérez J, Roosen K, Helms J. Interdisziplinäre Beurteilung und operative Therapie von Akustikusneurinomen. Laryngorhinootologie 2004. [DOI: 10.1055/s-2003-818901] [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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Völter C, Helms J, Weissbrich B, Abele-Horn M. Die Rolle von M. pneumoniae bei der Bell'schen Parese. Laryngorhinootologie 2004. [DOI: 10.1055/s-2003-818911] [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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Abstract
The cochlear implantation, especially after bilateral operation provides a reliable and outstanding compensation in bilateral complete deafness or severe hearing impairment. Directional hearing can be restored with bilateral implantation so that warning signals are localized correctly and speech in noise is easier understood. Thus, rehabilitation is restored to a high degree. The involved expenses are severe, but are lower for the society when compared to the amount of money necessary to substitute a completely deaf patient lifelong.
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Affiliation(s)
- J Helms
- Universitätsklinik und Poliklinik für Hals-, Nasen- und Ohrenkranke, Universität Würzburg.
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Helms J. Zur Übergabe an Prof. Rettinger. Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-814138] [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: 10/26/2022]
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Helms J, Müller J, Schön F. Bilateral cochlear implantation, experiences and perspectives. Otolaryngol Pol 2004; 58:51-2. [PMID: 15101259] [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: 04/29/2023]
Affiliation(s)
- J Helms
- Univ. ENT Department, Wuerzburg
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Miclau T, Nacamuli R, Lu C, Thompson Z, Longaker M, Helms J. 467 DO ALL BONES HEAL THROUGH THE SAME PATHWAY? J Investig Med 2004. [DOI: 10.1136/jim-52-suppl1-466] [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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