0000000000088230
AUTHOR
Rudolf Seufert
Placenta-derived CD95 ligand causes liver damage in hemolysis, elevated liver enzymes, and low platelet count syndrome.
Background & Aims: The HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome is a life-threatening complication during pregnancy. The associated liver disease may be severe, and maternal hepatic complications may progress to the point that transplantation becomes necessary. CD95 (APO-1, Fas)-mediated apoptosis of liver cells is one of the major pathogenic mechanisms during liver disease. The interaction of CD95 with its ligand, CD95L(FasL), induces apoptosis and thus the source of the death-inducing ligand is critical for understanding the pathomechanism of liver damage involving the CD95-system. Methods: Sera from HELLP patients were analyzed and used in cell culture experiment…
Fertility After Ovarian Cystectomy: How Does Surgery Affect IVF/ICSI Outcomes?
Abstract Introduction For patients considering undergoing assisted reproductive techniques (ART), many concerns arise when persistent ovarian cysts are found. This large study aimed to determine how ovarian cyst removal affects success rates of IVF/ICSI therapies. Methods 550 patients who underwent an IVF/ICSI treatment between 2002 and 2011 with a persistent ovarian cyst ≤ 5 cm before treatment were analyzed retrospectively. 328 patientsʼ preference was to undergo a laparoscopic cystectomy and 222 patients opted for a conservative management. Control subjects included 13 552 patients undergoing IVF/ICSI at the same period of time without an ovarian cyst. Results After adjusting for age, pa…
CD8+CD45RA+CD27-CD28-T-cell subset in PBL of cervical cancer patients representing CD8+T-cells being able to recognize cervical cancer associated antigens provided by HPV 16 E7
Objective In response to antigenic stimulation, naive MHC-class I restricted and antigen-specific CD8+CD45RA+CD28+T-cells undergo clonal expansion and differentiate into CD8+CD45RO+ memory T-cells. Upon re- encounter with the nominal antigen, CD45RO+ T-cells are able to convert to CD8+CD45RA+CD28-T-cells displaying potent immune effector functions, including TNF-alpha production. This T-cell subpopulation constitutes a minor population in healthy individuals. In the present study we are currently evaluating whether this particular T-cell subset in PBL represents CD8+T-cells which may be able to recognize cervical cancer associated antigens provided by HPV 16 E7. Material and methods Flow-cy…
Aktuelle Aufgaben der Informationsverarbeitung in der Frauenheilkunde
Rapid development and innovative research in medical computer science influences physicians work. Not only new hardware but also network implementation changed the way of decision making techniques in medicine. The main reason for acceptance and distribution of the internet is the possibility to present information in a reasonable and contemporary way. A self-labeling of medical information by web authors and systematic critical appraisal of health-related internet information by third parties may help to filter harmful health information and to positively identify and select high quality information. The German Work Group for Information Technologies in Gynecology and Obstetrics (AIG) info…
Gonadal damage and options for fertility preservation in female and male cancer survivors.
It is estimated that in 2010, 1 in every 250 adults will be a childhood cancer survivor. Today, oncological surgery, radiotherapy and chemotherapy achieve relatively high rates of remission and long-term survival, yet are often detrimental to fertility. Quality of life is increasingly important to long-term survivors of cancer, and one of the major quality-of-life issues is the ability to produce and raise normal children. Developments in the near future in the emerging field of fertility preservation in cancer survivors promise to be very exciting. This article reviews the published literature, discusses the effects of cancer treatment on fertility and presents the options available today …
Risk Weighing in Twin Pregnancy
Multiple pregnancies are more often associated with complications than singleton pregnancies. In our retrospective study of 613 twin pregnancies the most important risk factors in twin pregnancies were premature labour before the 37th week of gestation and the premature rupture of the membrane. The increase of perinatal mortality and morbidity for twins might be primary the result of premature delivery.
Unterstützung klinisch-administrativer Aufgaben durch Personal Digital Assistants (PDAs) - Möglichkeiten und Grenzen
Personal digital assistants (PDAs) are increasingly used by many professional and private users. They replace and combine common calendars, directories, to-do-lists and much more. Supplemented by useful additional software they can assist the clinician in his daily routine work. This concerns typical medical information as well as administrative work but gets more importance with regard to the planned introduction of diagnosis related groups in Germany however. Exact coding of medical performance is essential for this future invoice system. How PDAs can be used convenient in this respect will be shown with examples from our department.
Reproduction beyond cancer: A message of hope for young women
Abstract Objective. Aggressive chemotherapy and radiotherapy or radical oncological surgery in young women with cancer has greatly enhanced these patients' life expectancy, but these treatments often cause infertility or premature ovarian failure due to a massive destruction of the ovarian reserve. The objective of this review is to discuss the effect of the various cancer treatments on fertility and present the various fertility sparing operations and fertility preservation strategies. Method. An extensive survey of the most up-to-date literature was performed. Results. This review discusses the impact of current cancer treatment on fertility potential and the various surgical and assisted…
Ausgeprägte Virilisierung in der Postmenopause - eine Falldarstellung
Severe postmenopausal virilization is a rare event in clinical practice. To evaluate ovarian or adrenal hyperandrogenism endocrine tests and imaging are useful diagnostic tools. We report a case of a postmenopausal woman with hirsutism and androgenetic alopecia. A malignant cause for the present disorder could be excluded by imaging. Selective venous sampling was administered with increased testosterone level of the right adrenal vein. Right adrenalectomy and right oophorctomy was recommended.
Concentrations of ovarian proteohormones as biological markers for the outcome of assisted reproductive technology
Objective: To assess whether the ovarian proteohormones inhibin A and B, pro-alpha-C and activin A could act as direct biological markers of a poorer or better response to ovulation induction or clinical conception through assisted reproductive technology (ART). Methods: Seventy-seven women who underwent ART were included in the study and were divided into two groups: (i) 46 women with sonographically documented follicular maturation; and (ii) 36 women who demonstrated inadequate follicle development. Blood samples were analyzed for inhibin A, inhibin B, pro-alpha-C, activin A and estradiol (E2) at day 3 of stimulation with recombinant follicle-stimulating hormone (rFSH) after pituitary dow…
Serum inhibin A, inhibin B, pro-alphaC, and activin A levels in women with idiopathic premature ovarian failure.
Serum inhibin A, inhibin B, pro-alphaC, and activin A levels in 30 women with idiopathic premature ovarian failure (POF), 30 postmenopausal women, and 30 age-matched fertile women were determined. Women with POF showed low levels of inhibin A and inhibin B, but not of activin A, whereas the levels of pro-alphaC were significantly higher than in postmenopausal women. Thus, the circulating level of pro-alphaC could be a marker for assessing residual ovarian function in women with POF.
Fertility in males after childhood, adolescent, and adult inguinal operations
Abstract Background/purpose Inguinal hernia repair and orchidopexy are among the most common operations in boys. The impact on future fertility has not been conclusively defined. This study evaluates sperm quality after previous inguinal surgery. Methods Spermiograms of men with a desire to conceive children were analyzed. History of previous inguinal surgery (hernia repair, orchidopexy, varicocele ligation) was correlated with sperm quality. Other influential factors (age, BMI, chronic medication, tobacco use) were also tested. Results A total of 333 patients were included. Overall, 12.6% of the subjects had undergone previous inguinal surgery. Of these, 17 (43%) were inguinal hernia repai…
The Association of Appendectomy, Adhesions, Tubal Pathology, and Female Infertility.
Background and Objectives: The aim of the study was to investigate a potential association between previous childhood appendectomy, tube pathology, and female infertility. Methods: We reviewed patients seeking care at the fertility clinic of our university medical center between 2006 and 2016. The history of previous appendectomy was extracted from hospital documentation and by telephone follow-up. Tubal patency was assessed by diagnostic laparoscopy and chromopertubation. Results: In our study cohort (N = 237), 24.9% (n = 59) had a history of previous appendectomy. Previous appendectomy, therefore, was about 3-fold more prevalent in women seeking fertility treatment than in the general pop…
Concentrations of inhibins and activin in women undergoing stimulation with recombinant follicle-stimulating hormone for in vitro fertilization treatment
To investigate the influence of human recombinant follicle-stimulating hormone (FSH) on circulating serum concentrations of the ovarian proteohormones inhibin A, inhibin B, pro alpha-C, and activin A and serum levels of estradiol after down-regulation with GnRH analogue.Serum concentrations of ovarian proteohormones and estradiol.Academic clinical practice.30 women who underwent assisted reproductive techniques.Blood samples were analyzed for inhibin A, inhibin B, pro alpha-C, activin A, and estradiol during IVF treatment at points coinciding with pituitary down-regulation, stimulation with recombinant FSH, ovulatory triggering, and the luteal phase of the cycle.Activin A levels did not cha…
The effect of cancer treatment on female fertility and strategies for preserving fertility.
Aggressive chemotherapy and radiotherapy in young patients with cancer has greatly enhanced the life expectancy of these patients, but these treatments often cause infertility because of the massive destruction of the ovarian reserve resulting in premature ovarian failure (POF). This review focuses on the effect of cancer treatments on fertility and on the various surgical and assisted-reproduction innovations that are available to provide the patient with the option of future pregnancies. As the emerging discipline of fertility preservation is steadily attracting increasing interest, developments in the near future promise to be very exciting. However, in everyday routine work, better inte…