56 research outputs found
Cancer Testis Antigen Expression in gastrointestinalen Stromatumoren: neue Marker für frühe Rezidive
No full textZielgerichtete gynäko-onkologische Therapien - häufige Nebenwirkungen und deren Management
No full textZusammenfassung: Eine gute interdisziplinäre Zusammenarbeit ist in der Behandlung von Patientinnen mit Brustkrebs oder gynäkologisch-onkologischen Tumoren entscheidend. Meistens finden parallel zur onkologischen Behandlung regelmässige Konsultationen beim Allgemeinpraktiker und niedergelassenen Gynäkologen statt. Die Erkennung und frühe Behandlung potenzieller Nebenwirkungen von zielgerichteten onkologischen Therapien ist daher in der allgemeinen Praxis sehr wichtig. In diesem Artikel soll ein Überblick über die wichtigsten Nebenwirkungen zielgerichteter onkologischer Therapien in der gynäkologischen Onkologie und Brustkrebsbehandlung und deren Management gegeben werden
Beurteilung der operativen Dringlichkeit in 343 Eileiterschwangerschaften – die Bedeutung von freiem intraabdominalem Blut in der Transvaginalsonografie
No full textOBJECTIVES
Assessing urgency in ectopic pregnancies (ECP) remains controversial since the disorder covers a large clinical spectrum. Severe conditions such as acute abdomen or hemodynamic instability are mostly related to intra-abdominal blood loss diagnosed as free fluid (FF) on transvaginal sonography (TVS). The aims of the current study were to investigate the value of FF and to assess other potentially predictive parameters for judging urgency.
METHODS
Retrospective cohort analysis on prospectively collected cases of proven ECP (n = 343). Demographics, clinical and laboratory parameters, and findings on TVS and laparoscopy (LSC) were extracted from the digital patient file. FF on TVS and free blood (FB) in LSC were evaluated. Low urgency was defined as FB (LSC) < 100 ml and high urgency as FB (LSC) ≥ 300 ml. The best subset of variables for the prediction of FB was selected and predictors of urgency were evaluated using receiver operator characteristic (ROC) curves.
RESULTS
Clinical symptoms, age, β-HCG, hemoglobin (HB) preoperative, and FF were examined in multivariate analysis for the cutoff values of 100 ml and 300 ml. FF was the only independent predictor for low and high urgency; HB preoperative was only significant for high urgency offering marginal improvement. ROC analysis revealed FF as an excellent discriminatory parameter for defining low (AUC 0.837, 95% CI 0.794-0.879) and high urgency (AUC 0.902, 95 % CI 0.860-0.945).
CONCLUSION
Single assessment of FF on TVS is most valuable for judging urgency. However, the exact cutoff values for a low- and high-risk situation must still be defined
Endometriose-assoziierte Malignome. Eine Übersicht über Pathomechanismen und therapeutische Optionen
Get PDFThe immunohistochemical expression of GPER and classical sex hormone receptors differs in adenomyosis and eutopic endometrium
No full textG protein-coupled estrogen receptor (GPER) has been found to be an important key regulator in the homeostasis of sex hormone-dependent human cells. The aim of this study was to compare the expression of GPER, estrogen receptor alpha (ER-α), estrogen receptor beta (ER-β) and progesterone receptor (PR) in adenomyosis, eutopic endometrium from the same patients, and eutopic endometrium from patients without adenomyosis. Immunohistochemical analysis of GPER, ER-α, ER-β and PR was performed to assess the expression levels on samples of hysterectomies using tissue microarrays. 73 adenomyotic tissue probes and corresponding eutopic endometrial specimens, as well as 48 samples of eutopic endometrial control specimens from patients without adenomyosis were included in this study. Mean age of the women with adenomyosis was 51.7 (SD ± 11.1) and 65.8% were premenopausal. We found a higher nuclear stromal expression of GPER in eutopic endometrium of patients with adenomyosis in comparison to control endometrium (p < 0.001). Comparing adenomyosis to eutopic endometrium of patients with adenomyosis and to control, there was a lower expression of nuclear GPER in epithelial cells (p < 0.001 and p = 0.048, respectively). Lower epithelial nuclear ER-α in adenomyosis and higher epithelial nuclear ER-β in eutopic endometrium of patients with adenomyosis was found in comparison to control endometrium (p = 0.008 and p = 0.017, respectively). This study showed a significant difference in the immunohistochemical expression of GPER in adenomyosis compared to eutopic endometrium of the same patients and to endometrium of control group. GPER in adenomyosis may be a potential therapeutic target for selective agonists and antagonists.
Keywords: Adenomyosis; Estrogen Receptor; G protein-coupled estrogen receptor; GPER; Immunohistochemistry; Progesterone Receptor
Medikamentöse Therapie der Endometriose
Get PDFEndometriose, definiert als das Vorhandensein und Proliferieren von endometriumartigem Gewebe ausserhalb
des Cavum uteri, ist eine häufige Ursache für chronische Unterbauchschmerzen, Dysmenorrhö und Sterilität. Insbesondere die medikamentöse Therapie ist angesichts der immer noch ungeklärten Pathophysiologie häufig eher symptom- als kausalorientiert
Pathogenese der Endometriose
Get PDFEin grundlegendes Verständnis der Pathogenese der Endometriose ist eine zwingende Voraussetzung zur Etablierung neuer und wirksamer Therapieoptionen. Dabei erscheint die Endometriose als heterogene Gruppe von Krankheitsformen, die sich unterschiedlich manifestieren. Dies erklärt, weshalb die genaue Pathogenese der Endometriose bis heute ein nicht abschliessend erforschtes Gebiet bleibt
Maligne Tumoren des Genitaltrakts: Zyklus-assoziierte gynäkologische Erkrankungen als Ursprung?
Get PDFExpression pattern of class I histone deacetylases in vulvar intraepithelial neoplasia and vulvar cancer: A tissue microarray study
Get PDFBACKGROUND: Epigenetic regulation is an important mechanism leading to cancer initiation and promotion. Histone acetylation by histone deacetylases (HDACs) represents an important part of it. The development of HDAC inhibitors has identified the utility of HDACs as a therapeutic target. Little is known about the epigenetic regulation of vulvar intraepithelial neoplasia (VIN) and vulvar squamous cell cancer (VSCC). In this study, the expression of class I HDACs (HDAC 1, 2 and 3) was compared in a series of VIN and VSCC tissues. METHODS: A tissue micro array (TMA) with specimens from 106 patients with high-grade VIN and 59 patients with vulvar cancer was constructed. The expression of HDACs 1, 2 and 3 were analyzed with immunohistochemistry (IHC). The nuclear expression pattern was evaluated in terms of intensity and percentage of stained nuclei and was compared between vulvar preinvasive lesions and vulvar cancer. RESULTS: HDAC 2 expression was significantly higher in VIN than in VSCC (p < 0.001, Fisher's test). Also, 88.7% (n=94/106) of VIN samples and only 54.5% (n=31/57) of VSCC samples were scored at the maximum level. Conversely, HDAC 3 expression was significantly higher in VSCC (93%, 53/57) compared to VIN (73.6%, 78/106, p=0.003), whereas only a small difference in the expression of HDAC 1 was found between these two entities of vulvar neoplasia. CONCLUSIONS: These results suggest that epigenetic regulation plays a considerable role in the transformation of VIN to invasive vulvar neoplasia
Endometriose – eine epigenetische Erkrankung?
Get PDFEndometriose wird in ihrer Pathogenese bis heute nur unzureichend verstanden. Dies hat zur Folge, dass die Therapieoptionen, insbesondere die nicht-chirurgischen Behandlungen, nicht kausal ausgelegt sind und viele Fragen bei der betroffenen Patientin wie beim Arzt offen bleiben. Gerade das genaue Verständnis der frühen Phasen der Endometrioseentstehung und ihrer molekularen Vorgänge wären aber in der Entwicklung neuer nicht-chirurgischer Behandlungspläne sehr hilfreich und dringend nötig
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