2.Possibilities and challenges of telesurgical interventions.
Mathias RATH ; Markus HOHENFELLNER
Chinese Medical Journal 2025;138(10):1184-1185
3.Epidural pressure is a major driver of elevated intraspinal pressure after traumatic spinal cord injury and laminectomy in pigs
Nicholas Østergaard OLSEN ; Mathias Møller THYGESEN ; Seyar ENTEZARI ; Nanna Kaae HOULIND ; Mathias SKOV ; Michael PEDERSEN ; Mikkel Mylius RASMUSSEN
Journal of Neurocritical Care 2025;18(2):84-94
Background:
Elevated intraspinal pressure (ISP) driven by cord swelling is hypothesized to cause secondary injuries following trauma. We previously observed comparable ISP elevations in pigs undergoing traumatic spinal cord injury (TSCI) and sham operations (standalone laminectomy), suggesting the presence of other drivers.
Methods:
Using a porcine model, we assessed whether ISP elevation was compartment specific, related to cerebrospinal fluid (CSF) restoration, or driven by epidural pressure. In three corresponding sub-studies, the ISP was measured in the spinal cord, subdural, and epidural compartments after TSCI (n=5), and the effects of CSF drainage (n=3) and leaving the surgical wound open were tested (n=6).
Results:
The spinal cord and subdural ISP increased comparably, validating subdural ISP as a proxy for spinal cord pressure. CSF drainage attempts yielded no fluid and did not affect the subdural ISP. Correspondingly, magnetic resonance imaging revealed that the CSF was displaced by a higher degree of epidural compression than by spinal cord swelling. Leaving the wound open reduced ISP 2.5-fold more than the TSCI itself, further implicating epidural pressure from post-laminectomy swelling as a major driver of elevated ISP.
Conclusion
Epidural pressure influences elevated ISP following TSCI and laminectomy, rather than spinal cord swelling alone or CSF reconstitution. These findings suggest caution against external compression after laminectomy and call for further investigation of elevated ISP in patients with TSCI.
4.Personalized Treatment Strategy in “Low-Risk Prostate Cancer Active Surveillance Candidates” Using Irreversible Electroporation: Prospective Evaluation of Feasibility, Morbidity, Functional and Oncological Outcomes
Ionel Valentin POPENECIU ; Mirjam Naomi MOHR ; Arne STRAUSS ; Conrad LEITSMANN ; Lutz TROJAN ; Mathias REICHERT
The World Journal of Men's Health 2024;42(4):821-829
Purpose:
To evaluate the morbidity, functional and oncological outcome of irreversible electroporation (IRE) as a focal therapy for prostate cancer (PCa) when used in “active surveillance (AS)” candidates refusing standard treatment options.
Materials and Methods:
IRE was performed under general anaesthesia, and the transurethral catheter was removed one day after intervention in all patients. Pre- and post-interventional voiding parameters (measured by International Prostate Symptom Score Questionnaire [IPSS], uroflowmetry and post-void residue) were compared. Follow-up (FU) was observed over a minimum of six months, including oncological outcome (controlled by multiparametric magnetic resonance imaging, rebiopsy, prostate-specific antigen dynamic as well as the need and type of secondary treatment) and general functional outcome (International Index of Erectile Function Questionnaire, satisfaction of the procedure).
Results:
Twenty-four patients refusing AS or standard treatment with a median FU of 18.7 months were included. IPSS showed nine patients with mild, 12 with moderate and two with severe obstructive voiding symptoms pre-intervention (focal IRE). Median IPSS pre-IRE was 9 points, 8.5 (p=0.341) at six months and 10 (p=0.392) after 12 months, respectively. Pre-IRE maximum urinary flow (Qmax) (median: 16.1±8.0 mL/sec) and Qmax after catheter removal (16.2±7.6 mL/sec) did not differ significantly (p=0.904). Thirteen PCa recurrences occurred (54.2%). Out-of-lesion-PCa was found in 12/13 patients (92.3%), while 4/13 patients showed in-lesion-PCa recurrence simultaneously (30.8%). In one patient, there was an in-lesion-PCa recurrence only (7.7%). Six out of 24 patients (25.0%) received a secondary treatment. All patients were satisfied with the IRE procedure.
Conclusions
Focal IRE underperforms regarding the overall oncological outcome and should not be offered as an equivalent therapy to established curative treatment strategies. Nevertheless, under a strict FU regimen, its lack of significant additional morbidity compared to an active surveillance strategy makes IRE a feasible alternative for low-risk PCa in highly selected patients as a personalised approach.
5.PEG-PLGA nanoparticles deposited in Pseudomonas aeruginosa and Burk h olderia cenocepacia.
Tinatini TCHATCHIASHVILI ; Helena DUERING ; Lisa MUELLER-BOETTICHER ; Christian GRUNE ; Dagmar FISCHER ; Mathias W PLETZ ; Oliwia MAKAREWICZ
Journal of Pharmaceutical Analysis 2024;14(12):100939-100939
In our prior research, polymer nanoparticles (NPs) containing tobramycin displayed robust antibacterial efficacy against biofilm-embedded Pseudomonas aeruginosa (P. aeruginosa) and Burkholderia cenocepacia (B. cenocepacia) cells, critical pathogens in cystic fibrosis. In the current study, we investigated the deposition of a nanoparticulate carrier composed of poly(d,l-lactic-co-glycolic acid) (PLGA) and poly(ethylene glycol)-block-PLGA (PEG-PLGA) that was either covalently bonded with cyanine-5-amine (Cy5) or noncovalently bound with freely embedded cationic rhodamine B (RhB), which served as a drug surrogate. After exposing these NPs to bacteria, we performed cell fractionation and fluorescence analysis, which highlighted the accumulation of Cy5 in the outer membranes (OMs) and the accumulation of RhB in the cytoplasm (CP) of cells. The results indicated that these organic NPs are effective vehicles for targeted antibiotic delivery in bacterial cells, explaining the observed increase in the efficacy of encapsulated tobramycin against biofilms. This work emphasizes the potential of PEG-PLGA-based formulations for advanced drug delivery strategies.
6.Personalized Treatment Strategy in “Low-Risk Prostate Cancer Active Surveillance Candidates” Using Irreversible Electroporation: Prospective Evaluation of Feasibility, Morbidity, Functional and Oncological Outcomes
Ionel Valentin POPENECIU ; Mirjam Naomi MOHR ; Arne STRAUSS ; Conrad LEITSMANN ; Lutz TROJAN ; Mathias REICHERT
The World Journal of Men's Health 2024;42(4):821-829
Purpose:
To evaluate the morbidity, functional and oncological outcome of irreversible electroporation (IRE) as a focal therapy for prostate cancer (PCa) when used in “active surveillance (AS)” candidates refusing standard treatment options.
Materials and Methods:
IRE was performed under general anaesthesia, and the transurethral catheter was removed one day after intervention in all patients. Pre- and post-interventional voiding parameters (measured by International Prostate Symptom Score Questionnaire [IPSS], uroflowmetry and post-void residue) were compared. Follow-up (FU) was observed over a minimum of six months, including oncological outcome (controlled by multiparametric magnetic resonance imaging, rebiopsy, prostate-specific antigen dynamic as well as the need and type of secondary treatment) and general functional outcome (International Index of Erectile Function Questionnaire, satisfaction of the procedure).
Results:
Twenty-four patients refusing AS or standard treatment with a median FU of 18.7 months were included. IPSS showed nine patients with mild, 12 with moderate and two with severe obstructive voiding symptoms pre-intervention (focal IRE). Median IPSS pre-IRE was 9 points, 8.5 (p=0.341) at six months and 10 (p=0.392) after 12 months, respectively. Pre-IRE maximum urinary flow (Qmax) (median: 16.1±8.0 mL/sec) and Qmax after catheter removal (16.2±7.6 mL/sec) did not differ significantly (p=0.904). Thirteen PCa recurrences occurred (54.2%). Out-of-lesion-PCa was found in 12/13 patients (92.3%), while 4/13 patients showed in-lesion-PCa recurrence simultaneously (30.8%). In one patient, there was an in-lesion-PCa recurrence only (7.7%). Six out of 24 patients (25.0%) received a secondary treatment. All patients were satisfied with the IRE procedure.
Conclusions
Focal IRE underperforms regarding the overall oncological outcome and should not be offered as an equivalent therapy to established curative treatment strategies. Nevertheless, under a strict FU regimen, its lack of significant additional morbidity compared to an active surveillance strategy makes IRE a feasible alternative for low-risk PCa in highly selected patients as a personalised approach.
7.PEG-PLGA nanoparticles deposited in Pseudomonas aeruginosa and Burkholderia cenocepacia
Tchatchiashvili TINATINI ; Duering HELENA ; Mueller-Boetticher LISA ; Grune CHRISTIAN ; Fischer DAGMAR ; W.Pletz MATHIAS ; Makarewicz OLIWIA
Journal of Pharmaceutical Analysis 2024;14(12):1859-1867
In our prior research,polymer nanoparticles(NPs)containing tobramycin displayed robust antibacterial efficacy against biofilm-embedded Pseudomonas aeruginosa(P.aeruginosa)and Burkholderia cenocepacia(B.cenocepacia)cells,critical pathogens in cystic fibrosis.In the current study,we investigated the deposition of a nanoparticulate carrier composed of poly(D,L-lactic-co-glycolic acid)(PLGA)and poly(-ethylene glycol)-block-PLGA(PEG-PLGA)that was either covalently bonded with cyanine-5-amine(Cy5)or noncovalently bound with freely embedded cationic rhodamine B(RhB),which served as a drug surrogate.After exposing these NPs to bacteria,we performed cell fractionation and fluorescence analysis,which highlighted the accumulation of Cy5 in the outer membranes(OMs)and the accumu-lation of RhB in the cytoplasm(CP)of cells.The results indicated that these organic NPs are effective vehicles for targeted antibiotic delivery in bacterial cells,explaining the observed increase in the efficacy of encapsulated tobramycin against biofilms.This work emphasizes the potential of PEG-PLGA-based formulations for advanced drug delivery strategies.
8.Personalized Treatment Strategy in “Low-Risk Prostate Cancer Active Surveillance Candidates” Using Irreversible Electroporation: Prospective Evaluation of Feasibility, Morbidity, Functional and Oncological Outcomes
Ionel Valentin POPENECIU ; Mirjam Naomi MOHR ; Arne STRAUSS ; Conrad LEITSMANN ; Lutz TROJAN ; Mathias REICHERT
The World Journal of Men's Health 2024;42(4):821-829
Purpose:
To evaluate the morbidity, functional and oncological outcome of irreversible electroporation (IRE) as a focal therapy for prostate cancer (PCa) when used in “active surveillance (AS)” candidates refusing standard treatment options.
Materials and Methods:
IRE was performed under general anaesthesia, and the transurethral catheter was removed one day after intervention in all patients. Pre- and post-interventional voiding parameters (measured by International Prostate Symptom Score Questionnaire [IPSS], uroflowmetry and post-void residue) were compared. Follow-up (FU) was observed over a minimum of six months, including oncological outcome (controlled by multiparametric magnetic resonance imaging, rebiopsy, prostate-specific antigen dynamic as well as the need and type of secondary treatment) and general functional outcome (International Index of Erectile Function Questionnaire, satisfaction of the procedure).
Results:
Twenty-four patients refusing AS or standard treatment with a median FU of 18.7 months were included. IPSS showed nine patients with mild, 12 with moderate and two with severe obstructive voiding symptoms pre-intervention (focal IRE). Median IPSS pre-IRE was 9 points, 8.5 (p=0.341) at six months and 10 (p=0.392) after 12 months, respectively. Pre-IRE maximum urinary flow (Qmax) (median: 16.1±8.0 mL/sec) and Qmax after catheter removal (16.2±7.6 mL/sec) did not differ significantly (p=0.904). Thirteen PCa recurrences occurred (54.2%). Out-of-lesion-PCa was found in 12/13 patients (92.3%), while 4/13 patients showed in-lesion-PCa recurrence simultaneously (30.8%). In one patient, there was an in-lesion-PCa recurrence only (7.7%). Six out of 24 patients (25.0%) received a secondary treatment. All patients were satisfied with the IRE procedure.
Conclusions
Focal IRE underperforms regarding the overall oncological outcome and should not be offered as an equivalent therapy to established curative treatment strategies. Nevertheless, under a strict FU regimen, its lack of significant additional morbidity compared to an active surveillance strategy makes IRE a feasible alternative for low-risk PCa in highly selected patients as a personalised approach.
9.Personalized Treatment Strategy in “Low-Risk Prostate Cancer Active Surveillance Candidates” Using Irreversible Electroporation: Prospective Evaluation of Feasibility, Morbidity, Functional and Oncological Outcomes
Ionel Valentin POPENECIU ; Mirjam Naomi MOHR ; Arne STRAUSS ; Conrad LEITSMANN ; Lutz TROJAN ; Mathias REICHERT
The World Journal of Men's Health 2024;42(4):821-829
Purpose:
To evaluate the morbidity, functional and oncological outcome of irreversible electroporation (IRE) as a focal therapy for prostate cancer (PCa) when used in “active surveillance (AS)” candidates refusing standard treatment options.
Materials and Methods:
IRE was performed under general anaesthesia, and the transurethral catheter was removed one day after intervention in all patients. Pre- and post-interventional voiding parameters (measured by International Prostate Symptom Score Questionnaire [IPSS], uroflowmetry and post-void residue) were compared. Follow-up (FU) was observed over a minimum of six months, including oncological outcome (controlled by multiparametric magnetic resonance imaging, rebiopsy, prostate-specific antigen dynamic as well as the need and type of secondary treatment) and general functional outcome (International Index of Erectile Function Questionnaire, satisfaction of the procedure).
Results:
Twenty-four patients refusing AS or standard treatment with a median FU of 18.7 months were included. IPSS showed nine patients with mild, 12 with moderate and two with severe obstructive voiding symptoms pre-intervention (focal IRE). Median IPSS pre-IRE was 9 points, 8.5 (p=0.341) at six months and 10 (p=0.392) after 12 months, respectively. Pre-IRE maximum urinary flow (Qmax) (median: 16.1±8.0 mL/sec) and Qmax after catheter removal (16.2±7.6 mL/sec) did not differ significantly (p=0.904). Thirteen PCa recurrences occurred (54.2%). Out-of-lesion-PCa was found in 12/13 patients (92.3%), while 4/13 patients showed in-lesion-PCa recurrence simultaneously (30.8%). In one patient, there was an in-lesion-PCa recurrence only (7.7%). Six out of 24 patients (25.0%) received a secondary treatment. All patients were satisfied with the IRE procedure.
Conclusions
Focal IRE underperforms regarding the overall oncological outcome and should not be offered as an equivalent therapy to established curative treatment strategies. Nevertheless, under a strict FU regimen, its lack of significant additional morbidity compared to an active surveillance strategy makes IRE a feasible alternative for low-risk PCa in highly selected patients as a personalised approach.
10.Personalized Treatment Strategy in “Low-Risk Prostate Cancer Active Surveillance Candidates” Using Irreversible Electroporation: Prospective Evaluation of Feasibility, Morbidity, Functional and Oncological Outcomes
Ionel Valentin POPENECIU ; Mirjam Naomi MOHR ; Arne STRAUSS ; Conrad LEITSMANN ; Lutz TROJAN ; Mathias REICHERT
The World Journal of Men's Health 2024;42(4):821-829
Purpose:
To evaluate the morbidity, functional and oncological outcome of irreversible electroporation (IRE) as a focal therapy for prostate cancer (PCa) when used in “active surveillance (AS)” candidates refusing standard treatment options.
Materials and Methods:
IRE was performed under general anaesthesia, and the transurethral catheter was removed one day after intervention in all patients. Pre- and post-interventional voiding parameters (measured by International Prostate Symptom Score Questionnaire [IPSS], uroflowmetry and post-void residue) were compared. Follow-up (FU) was observed over a minimum of six months, including oncological outcome (controlled by multiparametric magnetic resonance imaging, rebiopsy, prostate-specific antigen dynamic as well as the need and type of secondary treatment) and general functional outcome (International Index of Erectile Function Questionnaire, satisfaction of the procedure).
Results:
Twenty-four patients refusing AS or standard treatment with a median FU of 18.7 months were included. IPSS showed nine patients with mild, 12 with moderate and two with severe obstructive voiding symptoms pre-intervention (focal IRE). Median IPSS pre-IRE was 9 points, 8.5 (p=0.341) at six months and 10 (p=0.392) after 12 months, respectively. Pre-IRE maximum urinary flow (Qmax) (median: 16.1±8.0 mL/sec) and Qmax after catheter removal (16.2±7.6 mL/sec) did not differ significantly (p=0.904). Thirteen PCa recurrences occurred (54.2%). Out-of-lesion-PCa was found in 12/13 patients (92.3%), while 4/13 patients showed in-lesion-PCa recurrence simultaneously (30.8%). In one patient, there was an in-lesion-PCa recurrence only (7.7%). Six out of 24 patients (25.0%) received a secondary treatment. All patients were satisfied with the IRE procedure.
Conclusions
Focal IRE underperforms regarding the overall oncological outcome and should not be offered as an equivalent therapy to established curative treatment strategies. Nevertheless, under a strict FU regimen, its lack of significant additional morbidity compared to an active surveillance strategy makes IRE a feasible alternative for low-risk PCa in highly selected patients as a personalised approach.


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