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Klotz DM, Kuhlmann JD, Schott S, Klink B, Grützmann K, Puppe J, Wauer US, Schröck E, Wimberger P. Die Wirkung des konjugierten Antimetabolit-Wirkstoffes 5-FdU-ECyd auf platinresistente Ovarialkarzinomzellen in vitro. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Eichler C, Langer L, Puppe J, Warm M, Malter W, Noé KG, Sauerwald A. Die zyklische biomechanische Testung der Pectopexie – eine experimentelle Vergleichsstudie. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Eichler C, Fromme J, Puppe J, Malter W, Paepke S, Warm M. Gene expression profiling in clinical practice The impact of Oncotype DX and EndoPredict on decision making with increasing oncological work experience. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Junker P, Puppe J, Thangarajah F, Domröse C, Cepic A, Morgenstern B, Ratiu D, Hellmich M, Mallmann P, Wirtz M. Neoadjuvant Therapy of Cervical Carcinoma with the Angiogenesis Inhibitor Bevacizumab: a Single-Centre Analysis. Geburtshilfe Frauenheilkd 2018; 78:768-774. [PMID: 30158716 PMCID: PMC6109715 DOI: 10.1055/a-0641-5588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 06/07/2018] [Accepted: 06/08/2018] [Indexed: 01/28/2023] Open
Abstract
Introduction
Cervical cancer is the fourth most frequent cancer in women worldwide. Addition of the VEGF antibody bevacizumab in combination with platinum-containing chemotherapy achieved an improvement in overall survival in advanced cervical cancer. To date there are no data on neoadjuvant use of bevacizumab. We therefore studied the benefit of neoadjuvant combined therapy with bevacizumab in a group of cervical cancer patients.
Patients and Methods
This retrospective cohort study analysed 14 patients with cervical cancer FIGO stages 1b1 to IV who received neoadjuvant platinum-containing chemotherapy in combination with bevacizumab. The comparative cohort consisted of 16 patients who were treated with neoadjuvant platinum-containing chemotherapy alone. The response rates were determined by means of preoperative clinical examination, diagnostic imaging (RECIST), changes in tumour markers (SCC) and by histopathology.
Results
A clinical response was found in 93.8% (n = 15) of patients after bevacizumab-free therapy and in 100% (n = 14) of the patients who were treated with bevacizumab in addition. Combined therapy with bevacizumab led to a higher rate of clinical complete remission (42.9 vs. 12.5%; p = 0.072) and significantly improved the reduction in tumour size (Δ longest diameter: 3.7 vs. 2.5 cm; p = 0.025). Downgrading was observed in 100% of all patients treated with bevacizumab compared with 75% in the control arm. The rate of pathological complete remission (pCR) was not altered significantly (28.6% [n = 4] vs. 37.5% [n = 6]; p = 0.460).
Discussion
Overall, combined therapy with bevacizumab led to a better clinical response. Operability was therefore improved more often. Because of the small patient cohort, larger prospective studies are necessary to validate the effect of neoadjuvant combined therapy with bevacizumab.
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Kuhlmann JD, Schott S, Klink B, Grützmann K, Puppe J, Wauer US, Klotz DM, Schröck E, Wimberger P. Die Wirkung des konjugierten Antimetabolit-Wirkstoffes 5-FdU-ECyd auf platinresistente Ovarialkarzinomzellen in vitro. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1645899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Eichler C, Efremova J, Brunnert K, Kurbacher CM, Gluz O, Puppe J, Warm M. A Head to Head Comparison Between SurgiMend® - Fetal Bovine Acellular Dermal Matrix and Tutomesh® - A Bovine Pericardium Collagen Membrane in Breast Reconstruction in 45 Cases. ACTA ACUST UNITED AC 2018; 31:677-682. [PMID: 28652438 DOI: 10.21873/invivo.11112] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 05/07/2017] [Accepted: 05/08/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The use of acellular dermal matrices (ADM) has become a widely used option in breast reconstruction. A great deal of literature is available, totaling over 3,200 ADM reconstructions. Head-to-head comparisons between SurgiMend® and Tutomesh® are not yet reported. These are the first comparative clinical data reported on the use of Tutomesh® in breast reconstruction. Postoperative complication rates and costs for these devices were evaluated. PATIENTS AND METHODS This is a retrospective analysis of a 2-year experience with both SurgiMend® - fetal bovine acellular dermal matrix and Tutomesh® - a bovine pericardium collagen membrane in breast reconstruction in 45 cases from 2014-2015. RESULTS Forty-five patients received a total of 45 implant-based reconstructions using SurgiMend® (18 cases; 40%) or Tutomesh® (27 cases; 60%). Gross complication rates were 27.8% for SurgiMend® and 37.0% for Tutomesh® including hematoma, postoperative skin irritation, infection, red breast syndrome and revision surgery. The most common complication was postoperative red breast syndrome. Severe complications requiring revision surgery did not differ significantly in patients treated with SurgiMend® (0 cases, 0%) compared to Tutomesh® (1 case, 3.7%). CONCLUSION This retrospective analysis shows similar overall clinical complication rates for Tutomesh® and SurgiMend®. Severe complication rates are comparable to those reported in literature for both products. Although the retrospective nature of this work limits its clinical impact, it is possible to opt for the cheaper alternative (Tutomesh®).
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Eichler C, Abrar S, Puppe J, Arndt M, Ohlinger R, Hahn M, Warm M. Detection of Ductal Carcinoma In Situ by Ultrasound and Mammography: Size-dependent Inaccuracy. Anticancer Res 2017; 37:5065-5070. [PMID: 28870935 DOI: 10.21873/anticanres.11923] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 07/01/2017] [Accepted: 07/05/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Retrospective analysis of breast cancer imaging methods is a common tool for evaluating the effectiveness of ultrasound and mammography regarding ductal carcinoma in situ (DCIS). No large number subpopulation of pure DCIS has been reported. It is however known that mammography and ultrasound underestimate tumor dimension with increasing tumor size. We aimed to quantify this discrepancy. MATERIALS AND METHODS This retrospective analysis reviewed the ultrasound and mammography data from 173 patients with DCIS at the University of Cologne - Department of Gynecology and Obstetrics between the years 2007 and 2010. Of these 173 patients, 34 fulfilled the DCIS analysis requirements and were evaluated in this study. RESULTS Overall, ultrasound underestimated tumor size 79.4% of the time, while overestimating only 20.6% of the time. Mammography underestimated tumor size in 50%, overestimated in 38.2%, correctly estimating in 11.8%. Over and underestimation distributions differed drastically above and a cut-off point of ≤2 cm actual tumor size, with a significant shift toward severe underestimation by both methods above a tumor size of 2 cm. DCIS misestimation was defined as the absolute value of the difference between actual tumor size and pre-surgical measurement by an imaging method. Mean DCIS size misestimation (actual tumor size ≤2 cm) was 3 mm for ultrasound and 6.2 mm for mammography. CONCLUSION We support previous findings that ultrasound and mammography lose accuracy with increasing tumor size. Nonetheless, ultrasound may be more useful in estimation of DCIS size for tumors ≤2 cm than previously expected.
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Neimann J, Knabl J, Puppe J, Bayer CM, Gass P, Gabriel L, Seelbach-Goebel B, Lermann J, Schott S. Duty Rosters and Workloads of Obstetricians in Germany: Results of a Germany-wide Survey. Geburtshilfe Frauenheilkd 2017; 77:894-903. [PMID: 28845054 DOI: 10.1055/s-0043-110863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 05/05/2017] [Accepted: 05/09/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Compiling a daily hospital roster which complies with existing laws and tariff regulations and meets the requirements for ongoing professional training while also taking the legal regulations on the health of employees into account makes planning the duty roster a challenge. The aim of this study was to obtain a realistic picture of existing duty roster systems and of the current workloads of obstetricians in Germany. METHOD This online survey was sent to 2770 physicians training to become obstetricians or specializing in specific areas of obstetric care. The survey consisted of an anonymized 95-item questionnaire which collected data on different types of duty roster systems and the workload of obstetricians in Germany for the period from 17.02.2015 to 16.05.2015. RESULTS Out of a total of 2770 physicians who were contacted, 437 (16%) completed the questionnaire. Across all forms of care, the care provided outside normal working hours usually (75%) consisted of a combination of regular working times and on-call duty or even consisted entirely of standby duty. Level I perinatal centers were most likely 20% (n = 88) to have a shift system in place. Working a shift system was significantly more common in care facilities which had previously carried out a job analysis. The number of physicians in hospitals who are present during the night shift was higher in facilities with higher numbers of births and in facilities which offered higher levels of care. In addition to regularly working overtime and the fact that often not all the hours worked were recorded, it was notable that the systems used to compile duty rosters often did not comply with legal regulations or with collectively agreed working hours nor were they compatible with the staff planning requirements. OUTLOOK The results of this study show that the conditions of work, the working times, and the organization of working times in obstetric departments are in need of improvement. Recording the actual times worked together with an analysis of the activities performed during working times and while on standby would increase the level of transparency for employers and employees.
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Schott S, Wimberger P, Klink B, Grützmann K, Puppe J, Wauer US, Klotz DM, Schröck E, Kuhlmann JD. The conjugated antimetabolite 5-FdU-ECyd and its cellular and molecular effects on platinum-sensitive vs. -resistant ovarian cancer cells in vitro. Oncotarget 2017; 8:76935-76948. [PMID: 29100359 PMCID: PMC5652753 DOI: 10.18632/oncotarget.20260] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 06/29/2017] [Indexed: 12/21/2022] Open
Abstract
Background Resistance to platinum-based chemotherapy is a clinical challenge in the treatment of ovarian cancer (OC) and limits survival. Therefore, innovative drugs against platinum-resistance are urgently needed. Our therapeutic concept is based on the conjugation of two chemotherapeutic compounds to a monotherapeutic pro-drug, which is taken up by cancer cells and cleaved into active cytostatic metabolites. We explore the activity of the duplex-prodrug 5-FdU-ECyd, covalently linking 2'-deoxy-5-fluorouridine (5-FdU) and 3'-C-ethynylcytidine (ECyd), on platinum-resistant OC cells. Methods In vitro assays and RNA-Sequencing were applied for characterization of 5-FdU-ECyd treated platinum-sensitive A2780 and isogenic platinum-resistant A2780cis and independent platinum-resistant Skov-3-IP OC cells. Results Nano molar 5-FdU-ECyd concentrations induced a rapid dose-dependent decline of cell viability in platinum-sensitive and -resistant OC cells. The effect of 5-FdU-ECyd was accompanied by the formation of DNA double strand breaks and apoptosis induction, indicated by a strong increase of pro-apoptotic molecular markers. Moreover, 5-FdU-ECyd efficiently decreased migration of platinum-resistant OC cells and inhibited clonogenic or spheroidal growth. Transcriptome analysis showed early up-regulation of CDKN1A and c-Fos in both, platinum-resistant and -sensitive cells after 5-FdU-ECyd treatment and de-regulation of distinct cellular pathways involved in cell cycle regulation, apoptosis, DNA-damage response and RNA-metabolism. Combined treatment of 5-FdU-ECyd and cisplatin did not show a synergistic cellular response, suggesting the potential use of 5-FdU-ECyd as a monotherapeutic agent. Conclusion Our data provide novel mechanistic insight into the anti-tumor effect of 5-FdU-ECyd and we hypothesize that this duplex-prodrug could be a promising therapeutic option for OC patients with resistance to platinum-based chemotherapy.
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Puppe J, Schott S, Eismann S, Tzschaschel M, Rody A, Wöckel A, Lermann J, Gabriel L, Beckmann M, Gass P. Diskurs – Ist Forschung an deutschen Universitätsfrauenkliniken noch erwünscht, möglich und zielführend? – Zusammenfassung der Diskussionsrunde auf dem 61. DGGG-Kongress 2016 in Stuttgart. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0043-108143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Wimberger P, Klink B, Gruetzmann K, Puppe J, Klotz D, Schroeck E, Kuhlmann JD, Schott S. The activity of the conjugated antimetabolite 5-FdU-ECyd against platinum-resistant ovarian cancer. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e17077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e17077 Background: Primary or secondary resistance to platinum-based chemotherapy is an important clinical challenge in the treatment of ovarian cancer (OC) and limits survival. Therefore, the development of innovative drugs against platinum resistance is urgently needed. Our therapeutic concept is based on the conjugation of two chemotherapeutic compounds to a monotherapeutic pro-drug, which is taken up by cancer cells and is subsequently cleaved into several active cytostatic metabolites. Our in vitro study evaluates the effects of the conjugated antimetabolite 5-FdU-ECyd, consisting of 2-deoxy-5-fluorouridine (5-FdU) and ethynylcytidine (ECyd), on platinum-resistant OC cells. Methods: In vitro assays and RNA-Seq (Illumina) were applied for characterization of 5-FdU-ECyd treated platinum-sensitive A2780 and isogenic platinum-resistant A2780cis as well as independent platinum-resistant Skov-3-IP OC cells. Results: Nano molar 5-FdU-ECyd concentrations induced a rapid dose-dependent decline of cell viability in platinum-sensitive and platinum-resistant OC cells. The cytotoxicity of 5-FdU-ECyd was accompanied by the formation of DNA double strand breaks and by the induction of apoptosis, indicated by a strong increase of pro-apoptotic molecular markers (caspase-3/7 activation, PARP-cleavage). Moreover, 5-FdU-ECyd efficiently decreased cell migration of platinum-resistant OC cells and inhibited other tumor-associated cellular functions, such as clonogenic or spheroidal growth. Transcriptome analysis indicated that, independently of platinum-resistance status, 5-FdU-ECyd influences distinct cellular pathways, involved in cell cycle regulation, apoptosis, DNA-damage response and RNA/pyrimidine metabolism. Combination treatment of 5-FdU-ECyd and platin did not show a synergistic cellular response, suggesting the potential use of 5-FdU-ECyd as a monotherapeutic agent. Conclusions: Our data provide a rationale to characterize the effect of 5-FdU-ECyd in a pre-clinical in vivo setting. We hypothesize that this conjugate is a promising therapeutic option for OC patients with resistance to conventional platinum-based chemotherapy.
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Puppe J, van Ooyen D, Neise J, Thangarajah F, Eichler C, Krämer S, Pfister R, Mallmann P, Wirtz M, Michels G. Evaluation of QTc Interval Prolongation in Breast Cancer Patients after Treatment with Epirubicin, Cyclophosphamide, and Docetaxel and the Influence of Interobserver Variation. Breast Care (Basel) 2017; 12:40-44. [PMID: 28611540 DOI: 10.1159/000455065] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Chemotherapy with anthracyclines is associated with life-threatening electrocardiographic alterations including corrected QT (QTc) interval prolongation. PATIENTS AND METHODS In this study we assessed the effect of epirubicin, cyclophosphamide, and docetaxel (EC-Doc) on the QTc interval in 10 patients with early breast cancer. Cardiac toxicity was assessed with symptoms, transthoracic echocardiography, electrocardiography (ECG), and serum cardiac markers at baseline and after 4 cycles of EC and 4 cycles of docetaxel. To evaluate the influence of interobserver variation, the QTc interval was analyzed by a cardiologist, a gynecologist, and with automated ECG interpretation software. RESULTS There was a significant QTc prolongation after EC treatment independent of the investigator. In addition, a significant increase in N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels was noted after EC treatment. QTc prolongation and NT-proBNP levels normalized after docetaxel treatment. Other biochemical markers were within normal ranges. No clinically relevant effect on left ventricular ejection fraction was observed. CONCLUSION This prospective study demonstrated that EC treatment increases the QTc interval and NT-proBNP levels in women with early breast cancer. This effect was reversible and independent of docetaxel administration. Moreover, the treating physician can safely perform QTc interval evaluation as part of clinical routine independent of his/her specialty. Due to the small number of patients, further conclusions are limited at this point.
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Gabriel L, Lermann J, Schott S, Puppe J. Verabschiedung der Geschäftsordnung und Neuwahlen der Sprecher des Jungen Forums 2016–2018. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0042-116780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Puppe J, van de Ven M, van der Burg E, Boon U, van Tellingen O, Bouwman P, Mallmann P, Schmutzler R, van Lohuizen M, Jonkers J. EZH2 inhibition sensitizes BRCA1-deficient breast tumors to the PI3K inhibitor BKM120. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Wirtz M, Ulhaas A, Thangarajah F, Puppe J, Ratiu D, Fridrich C, Morgenstern B, Mallmann P. Experiences with off-lable use of bevacizumab in patients with first-diagnosed locally advanced and metastatic cervical cancer. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Puppe J, Opdam M, Jozwiak K, Schouten PC, Rodenhuis S, Hauptmann M, Hahnen E, Mallmann P, Schmutzler R, Linn S, Jonkers J. EZH2 is overexpressed in breast tumors with a BRCA1-like DNA copy number profile. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Puppe J, van Ooyen D, Neise J, Thangarajah F, Eichler C, Fridrich C, Morgenstern B, Pfister R, Mallmann P, Wirtz M, Michels G. Prospective evaluation of QTc-interval prolongation in patients with advanced ovarian cancer after treatment with carboplatin, paclitaxel and bevacizumab. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Thangarajah F, Mallmann P, Frommke L, Morgenstern B, Fridrich C, Puppe J, Krempel K, Markiefka B, Büttner R, Scheel AH, Schultheis AM. PD-1 und PD-L1 Expression in Plattenepithelkarzinomen der Vulva. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Frommke LM, Puppe J, Mallmann P, Wirtz M. Therapie eines triple-negativen Mammakarzinoms mit ausgeprägter kutaner Metastasierung mit Bevacizumab – eine Fallvorstellung. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Junker P, Domröse C, Puppe J, Mallmann P, Wirtz M. High-Grade MANEC der Zervix in der Schwangerschaft. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Rogée K, Thangarajah F, Puppe J, Morgenstern B, Mallmann P, Fridrich C. Morbidität nach Sentinellymphonodektomie beim Vulvakarzinom im Vergleich zur radikalen inguinofemoralen Lymphonodektomie. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Junker P, Wirtz M, Ulhaas A, Puppe J, Mallmann P. Operatives Outcome nach neoadjuvanter Gabe des VEGF Antikörpers Bevacizumab beim fortgeschrittenen Zervixkarzinom. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Eichler C, Schell J, Uener J, Prescher A, Scaal M, Puppe J, Warm M. Inframammary Fold Reconstruction: A Biomechanical Analysis. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e634. [PMID: 27257564 PMCID: PMC4874278 DOI: 10.1097/gox.0000000000000568] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Accepted: 10/28/2015] [Indexed: 11/25/2022]
Abstract
Background: Inframammary fold reconstruction has scarcely been evaluated in literature. No biomechanical analyses have been performed comparing different reconstructive methods. This evaluation compares the gold-standard suture reconstruction with an intrarib anchor system (Micro BioComposite SutureTak, Arthrex). Methods: Three analysis groups were compared including 8 Sawbone blocks, 22 embalmed cadaver, and 27 regular cadaver specimens (N = 57). Transient mechanical analysis was performed at 5 N/s using an Instron 5565 test frame. Results: Ultimate load favored the anchor system (compared with the gold-standard suture) by a factor of 9.8 (P < 0.0001) for the regular cadaver group and a factor of 1.7 (P < 0.038) for the embalmed cadaver group. A similar statistically significant benefit was shown for stiffness and load at 2-mm displacement. Conclusions: This analysis showed an anchor system to be the biomechanically superior fixation method in terms of ultimate load, fixation stiffness, and displacement at failure when compared with the gold-standard suture method in inframammary fold reconstruction. Because of superior stability in every aspect, an anchor system may be considered for inframammary fold reconstruction.
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Puppe J, Dieterich M, Bayer C, Neiman J, de Sousa Mendes M, Gaß P, Lermann J, Schott S. Senology in Gynaecology Specialist Training: a Baseline Survey from 2014. Geburtshilfe Frauenheilkd 2016; 76:564-569. [PMID: 27239066 DOI: 10.1055/s-0042-104055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Introduction: Qualified training in senology is essential for maintaining adequate, high quality patient care. In order to meet the needs of doctors in training and those of the medical infrastructure it is necessary to assess the quality of training regularly, to enable its adaption and optimisation. Methods: We developed a comprehensive, 10 item online questionnaire to assess the quality of specialised training in senology. This questionnaire was sent to 4000 speciality trainees and young specialists countrywide via the DGGG newsletter and was accessible for over four weeks. Results: 111 obstetrics and gynaecology speciality trainees participated in this national survey, 79 % of whom were female. 33 % of participants were working at university hospitals, 29 % at hospitals offering maximal level care without an associated medical faculty, 37 % at hospitals offering primary and secondary level care and 2 % at gynaecology practices. 25 % of participants could imagine working in the field of senology in future. On average the current perception of general specialist training was satisfactory. Specialist trainees at university hospitals rated training in senology highest (score: 2.95) compared to those at other hospitals. A fixed rotation through a breast centre offering comprehensive advanced training was seen as a potential improvement to senology training. Conclusions: This is the first survey of specialised training in senology to be conducted in Germany. Results showed that there is significant potential for young doctors to enter the speciality in future. There are also significant differences in the perceived quality of senology training between training facilities. This survey aimed to determine the quality of specialised training at senology centres and hopes to contribute to a sustainable improvement in training. The intention is to continue to make senology attractive to gynaecologists and to ensure well-grounded training.
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Gabriel L, Lermann J, Schott S, Puppe J. Weiterbildung mitgestalten. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0042-105014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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