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Klemenz AC, Albrecht L, Manzke M, Dalmer A, Böttcher B, Surov A, Weber MA, Meinel FG. Improved image quality in CT pulmonary angiography using deep learning-based image reconstruction. Sci Rep 2024; 14:2494. [PMID: 38291105 PMCID: PMC10827738 DOI: 10.1038/s41598-024-52517-2] [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] [Received: 11/20/2023] [Accepted: 01/19/2024] [Indexed: 02/01/2024] Open
Abstract
We investigated the effect of deep learning-based image reconstruction (DLIR) compared to iterative reconstruction on image quality in CT pulmonary angiography (CTPA) for suspected pulmonary embolism (PE). For 220 patients with suspected PE, CTPA studies were reconstructed using filtered back projection (FBP), adaptive statistical iterative reconstruction (ASiR-V 30%, 60% and 90%) and DLIR (low, medium and high strength). Contrast-to-noise ratio (CNR) served as the primary parameter of objective image quality. Subgroup analyses were performed for normal weight, overweight and obese individuals. For patients with confirmed PE (n = 40), we further measured PE-specific CNR. Subjective image quality was assessed independently by two experienced radiologists. CNR was lowest for FBP and enhanced with increasing levels of ASiR-V and, even more with increasing strength of DLIR. High strength DLIR resulted in an additional improvement in CNR by 29-67% compared to ASiR-V 90% (p < 0.05). PE-specific CNR increased by 75% compared to ASiR-V 90% (p < 0.05). Subjective image quality was significantly higher for medium and high strength DLIR compared to all other image reconstructions (p < 0.05). In CT pulmonary angiography, DLIR significantly outperforms iterative reconstruction for increasing objective and subjective image quality. This may allow for further reductions in radiation exposure in suspected PE.
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Affiliation(s)
- Ann-Christin Klemenz
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Schillingallee 36, 18057, Rostock, Germany
| | - Lasse Albrecht
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Schillingallee 36, 18057, Rostock, Germany
| | - Mathias Manzke
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Schillingallee 36, 18057, Rostock, Germany
| | - Antonia Dalmer
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Schillingallee 36, 18057, Rostock, Germany
| | - Benjamin Böttcher
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Schillingallee 36, 18057, Rostock, Germany
| | - Alexey Surov
- Department of Radiology, Mühlenkreiskliniken Minden, Ruhr-University Bochum, Bochum, Germany
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Schillingallee 36, 18057, Rostock, Germany
| | - Felix G Meinel
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Schillingallee 36, 18057, Rostock, Germany.
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Dalmer A, Meinel FG, Böttcher B, Manzke M, Lorbeer R, Weber MA, Baeßler B, Klemenz AC. Native myocardial T1 mapping: influence of spatial resolution on quantitative results and reproducibility. Quant Imaging Med Surg 2024; 14:20-30. [PMID: 38223095 PMCID: PMC10784086 DOI: 10.21037/qims-23-943] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/28/2023] [Indexed: 01/16/2024]
Abstract
Background Myocardial mapping techniques can be used to quantitatively assess alterations in myocardial tissue properties. This study aims to evaluate the influence of spatial resolution on quantitative results and reproducibility of native myocardial T1 mapping in cardiac magnetic resonance imaging (MRI). Methods In this cross-sectional study with prospective data collection between October 2019 and February 2020, 50 healthy adults underwent two identical cardiac MRI examinations in the radiology department on the same day. T1 mapping was performed using a MOLLI 5(3)3 sequence with higher (1.4 mm × 1.4 mm) and lower (1.9 mm × 1.9 mm) in-plane spatial resolution. Global quantitative results of T1 mapping were compared between high-resolution and low-resolution acquisitions using paired t-test. Intra-class correlation coefficient (ICC) and Bland-Altman statistics (absolute and percentage differences as means ± SD) were used for assessing test-retest reproducibility. Results There was no significant difference between global quantitative results acquired with high vs. low-resolution T1 mapping. The reproducibility of global T1 values was good for high-resolution (ICC: 0.88) and excellent for low-resolution T1 mapping (ICC: 0.95, P=0.003). In subgroup analyses, inferior test-retest reproducibility was observed for high spatial resolution in women compared to low spatial resolution (ICC: 0.71 vs. 0.91, P=0.001) and heart rates >77 bpm (ICC: 0.53 vs. 0.88, P=0.004). Apical segments had higher T1 values and variability compared to other segments. Regional T1 values for basal (ICC: 0.81 vs. 0.89, P=0.023) and apical slices (ICC: 0.86 vs. 0.92, P=0.024) showed significantly higher reproducibility in low-resolution compared to high-resolution acquisitions but without differences for midventricular slice (ICC: 0.91 vs. 0.92, P=0.402). Conclusions Based on our data, we recommend a spatial resolution on the order of 1.9 mm × 1.9 mm for native myocardial T1 mapping using a MOLLI 5(3)3 sequence at 1.5 T particularly in individuals with higher heart rates and women.
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Affiliation(s)
- Antonia Dalmer
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Felix G. Meinel
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Benjamin Böttcher
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Mathias Manzke
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Roberto Lorbeer
- Department of Radiology, Ludwig-Maximilian University, Munich, Germany
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Bettina Baeßler
- Institute of Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Ann-Christin Klemenz
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
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Böttcher B, Zsarnoczay E, Varga-Szemes A, Schoepf UJ, Meinel FG, van Assen M, De Cecco CN. Dual-Energy Computed Tomography in Cardiac Imaging. Radiol Clin North Am 2023; 61:995-1009. [PMID: 37758366 DOI: 10.1016/j.rcl.2023.05.004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Dual-energy computed tomography (DECT) acquires images using two energy spectra and offers a variation of reconstruction techniques for improved cardiac imaging. Virtual monoenergetic images decrease artifacts improving coronary plaque and stent visualization. Further, contrast attenuation is increased allowing significant reduction of contrast dose. Virtual non-contrast reconstructions enable coronary artery calcium scoring from contrast-enhanced scans. DECT provides advanced plaque imaging with detailed analysis of plaque components, indicating plaque stability. Extracellular volume assessment using DECT offers noninvasive detection of myocardial fibrosis. This review aims to outline the current cardiac applications of DECT, summarize recent literature, and discuss their findings.
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Affiliation(s)
- Benjamin Böttcher
- Division of Cardiothoracic Imaging, Department of Radiology and Imaging Sciences, Emory University Hospital, 1364 Clifton Road NE, Suite D112, Atlanta, GA 30322, USA; Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Ernst-Heydemann-Strasse 6, 18057 Rostock, Germany
| | - Emese Zsarnoczay
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Clinical Science Building, 96 Jonathan Lucas Street, Suite 210, MSC 323 Charleston, SC 29425, USA; MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Center, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary
| | - Akos Varga-Szemes
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Clinical Science Building, 96 Jonathan Lucas Street, Suite 210, MSC 323 Charleston, SC 29425, USA
| | - Uwe Joseph Schoepf
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Clinical Science Building, 96 Jonathan Lucas Street, Suite 210, MSC 323 Charleston, SC 29425, USA
| | - Felix G Meinel
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Ernst-Heydemann-Strasse 6, 18057 Rostock, Germany
| | - Marly van Assen
- Division of Cardiothoracic Imaging, Department of Radiology and Imaging Sciences, Emory University Hospital, 1364 Clifton Road NE, Suite D112, Atlanta, GA 30322, USA
| | - Carlo N De Cecco
- Division of Cardiothoracic Imaging and Imaging Informatics, Department of Radiology and Imaging Sciences, Emory University Hospital, Emory Healthcare, Inc. 1365 Clifton Road NE, Suite - AT503, Atlanta, GA 30322, USA.
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Heinrich A, Yücel S, Böttcher B, Öner A, Manzke M, Klemenz AC, Weber MA, Meinel FG. Improved image quality in transcatheter aortic valve implantation planning CT using deep learning-based image reconstruction. Quant Imaging Med Surg 2023; 13:970-981. [PMID: 36819291 PMCID: PMC9929406 DOI: 10.21037/qims-22-639] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 11/10/2022] [Indexed: 12/24/2022]
Abstract
Background This study aims to evaluate the impact of a novel deep learning-based image reconstruction (DLIR) algorithm on the image quality in computed tomographic angiography (CTA) for pre-interventional planning of transcatheter aortic valve implantation (TAVI). Methods We analyzed 50 consecutive patients (median age 80 years, 25 men) who underwent TAVI planning CT on a 256-dectector-row CT. Images were reconstructed with adaptive statistical iterative reconstruction V (ASIR-V) and DLIR. Intravascular image noise, edge sharpness, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were quantified for ascending aorta, descending aorta, abdominal aorta and iliac arteries. Two readers (one radiologist and one interventional cardiologist) scored task-specific subjective image quality on a five-point scale. Results DLIR significantly reduced median image noise by 29-57% at all anatomical locations (all P<0.001). Accordingly, median SNR improved by 44-133% (all P<0.001) and median CNR improved by 44-125% (all P<0.001). DLIR significantly improved subjective image quality for all four pre-specified TAVI-specific tasks (measuring the annulus, assessing valve morphology and calcifications, the coronary ostia, and the suitability of the aorto-iliac access route) for both the radiologist and the interventional cardiologist (P≤0.001). Measurements of the aortic annulus circumference, area and diameter did not differ between ASIR-V and DLIR reconstructions (all P>0.05). Conclusions DLIR significantly improves objective and subjective image quality in TAVI planning CT compared to a state-of-the-art iterative reconstruction without affecting measurements of the aortic annulus. This may provide an opportunity for further reductions in contrast medium volume in this population.
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Affiliation(s)
- Andra Heinrich
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Seyrani Yücel
- Department of Internal Medicine, Division of Cardiology, University Medical Centre Rostock, Rostock, Germany
| | - Benjamin Böttcher
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Alper Öner
- Department of Internal Medicine, Division of Cardiology, University Medical Centre Rostock, Rostock, Germany
| | - Mathias Manzke
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Ann-Christin Klemenz
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Felix G. Meinel
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
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Toth B, Tollinger S, Biasio W, Reiser E, Wildt L, Böttcher B. Erste erfolgreiche Ovartransplantation nach Stammzellchemotherapie in Österreich. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1750218] [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: 10/17/2022] Open
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Schiller J, Reiser E, Böttcher B, Ossig C, Toth B. Follow-up nach Fertilitätserhalt bei österreichischen Krebspatientinnen nach gonadotoxischer Behandlung. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1750217] [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: 10/17/2022] Open
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Reiser E, Vomstein K, Hofer-Tollinger S, Pinggera G, Strassgschwandtner E, Zippl AL, Böttcher B, Toth B. P–088 Sexual functioning is impaired in cancer survivors after cancer therapy. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Is impaired sexual functioning correlated to sperm quality in cancer survivors?
Summary answer
Erectile dysfunction affects 25.0% of cancer survivors, independent of sperm quality. 22.9% of patients show symptoms consistent with a reduced testosterone level.
What is known already
Gonadotoxic treatment in male cancer patients can end up in reversible or permanent impaired spermatogenesis, testosterone insufficiency, and sexual dysfunction.
Study design, size, duration
In this prospective single-center study, sexual functioning was assessed in male cancer survivors, who underwent sperm cryopreservation at the Department of Gynecological Endocrinology and Reproductive Medicine, Medical University Innsbruck, Austria from 01/2010 to 12/2018. Sexual functioning was assessed between 03–12/2020 via two questionnaires: Aging Male Score (AMS) and International Index of Erectile Function (IEEF-EF).
Participants/materials, setting, methods
Thirty-five cancer survivors (testicular cancer: n = 16 [45.7%], hematological malignancies: n = 15 [42.9%], others: n = 4 [n = 11.4%]) filled in two questionnaires (AMS and IEEF-EF) during routine follow-up visit at the Department of Gynecological Endocrinology and Reproductive Medicine, Medical University Innsbruck and the Department of Urology, Medical University Innsbruck, Austria. Moreover, sperm quality was assessed and normozoospermia was defined in accordance with the 2010 WHO criteria (sperm concentration ≥15 million/mL, progressive motility ≥32%, and ≥4% normal morphology).
Main results and the role of chance
Mean age at sperm cryopreservation and follow-up visit was 25.1±4.2 and 31.9±6.3 years, respectively with a mean follow-up time of 81.4±12.5 months. Rate of erectile dysfunction was low (75.0% no dysfunction, 15.6% low dysfunction, 3.1% low-moderate dysfunction, 3.1% moderate, 3.1% severe dysfunction). Moreover, AMS score indicated no, low, moderate and severe symptoms consistent with a low testosterone level in 77.1%, 8.6%, 2.9%, and 2.9% of patients, respectively. Oligozoospermia was observed in up to 48% of the patients with TM and in only 23% patients with HM. Patients with TM showed significantly reduced sperm count (18.7 × 106/mL [5.3–43.0]) and total sperm count (42.4 × 106/ejaculate [13.3–108.5]) compared to HM (p = 0.03). There was no difference in sexual functioning between patients with HM or TM. Sexual functioning did no correlate with sperm count, progressive motility or morphology.
Limitations, reasons for caution
Although the study may be limited by its small sample size, it is the first to assess a correlation of sperm quality and sexual dysfunction in cancer survivors.
Wider implications of the findings: As every fourth male cancer patient suffers from impaired sexual functioning after gonadotoxic treatment, this important topic should be addressed in clinical and scientific future. Future studies should focus on both, somatic and psychosomatic reasons for sexual dysfunction.
Trial registration number
none
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Affiliation(s)
- E Reiser
- Medical University Innsbruck, Department of Gynecological Endocrinology and Reproductive Medicine-, Innsbruck, Austria
| | - K Vomstein
- Medical University Innsbruck, Department of Gynecological Endocrinology and Reproductive Medicine-, Innsbruck, Austria
| | - S Hofer-Tollinger
- Medical University Innsbruck, Department of Gynecological Endocrinology and Reproductive Medicine-, Innsbruck, Austria
| | - G Pinggera
- Medical University Innsbruck, Department of Urology, Innsbruck, Austria
| | - E Strassgschwandtner
- Medical University Innsbruck, Department of Gynecological Endocrinology and Reproductive Medicine-, Innsbruck, Austria
| | - A L Zippl
- Medical University Innsbruck, Department of Gynecological Endocrinology and Reproductive Medicine-, Innsbruck, Austria
| | - B Böttcher
- Medical University Innsbruck, Department of Gynecological Endocrinology and Reproductive Medicine-, Innsbruck, Austria
| | - B Toth
- Medical University Innsbruck, Department of Gynecological Endocrinology and Reproductive Medicine-, Innsbruck, Austria
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Böttcher B, Lorbeer R, Stöcklein S, Beller E, Lang CI, Weber MA, Meinel FG. Global and Regional Test-Retest Reproducibility of Native T1 and T2 Mapping in Cardiac Magnetic Resonance Imaging. J Magn Reson Imaging 2021; 54:1763-1772. [PMID: 34075646 DOI: 10.1002/jmri.27755] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Mapping of T1 and T2 relaxation times in cardiac MRI is an invaluable tool for the diagnosis and risk stratification of a wide spectrum of cardiac diseases. PURPOSE To investigate the global and regional reproducibility of native T1 and T2 mapping and to analyze the influence of demographic factors, physiological parameters, slice position, and myocardial regions on reproducibility. STUDY TYPE Prospective single-center cohort-study. POPULATION Fifty healthy volunteers (29 female, 21 male) with a mean age of 39.4 ± 13.7 years. FIELD STRENGTH/SEQUENCE Each volunteer was investigated twice at 1.5 T using a modified look-locker inversion-recovery (MOLLI) sequence (T1 mapping) and a T2-prepared steady-state free precession (SSFP) sequence (T2 mapping). ASSESSMENT Global T1 and T2 values were quantified for the entire left ventricle in three short-axis slices. Regional T1 and T2 values were measured for each myocardial segment and for myocardial segments grouped by slice position and anatomical region. STATISTICAL TESTS Test-retest reproducibility was assessed using intraclass correlation coefficient (ICC) and Bland-Altman statistics. A P value < 0.05 was considered statistically significant. RESULTS Reproducibility was good for global T1 values (ICC 0.88) and excellent for global T2 values (ICC 0.91). Reproducibility of T1 values was excellent (ICC 0.91) for midventricular slice and good for apical (ICC 0.86) and basal slice (ICC 0.81). Reproducibility of T1 mapping values was highest in the septum (ICC 0.90) compared to the anterior (0.81), lateral (0.86), and inferior (0.86) wall. For T2 mapping, reproducibility was good for all slice positions (ICC 0.86 for midventricular, 0.83 for basal, and 0.80 for apical slice). Reproducibility of T2 mapping was significantly lower for the inferior wall (ICC 0.58) than for septum (0.89), anterior (0.85), and lateral (0.87) wall. DATA CONCLUSION Native T1 and T2 mapping has good to excellent reproducibility with significant regional differences. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Benjamin Böttcher
- Institute of Diagnostic and Interventional Radiology, Paediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Roberto Lorbeer
- Department of Radiology, Ludwig-Maximilian University, Munich, Germany
| | - Sophia Stöcklein
- Department of Radiology, Ludwig-Maximilian University, Munich, Germany
| | - Ebba Beller
- Institute of Diagnostic and Interventional Radiology, Paediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Cajetan I Lang
- Department of Internal Medicine, Division of Cardiology, University Medical Center Rostock, Rostock, Germany
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, Paediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
| | - Felix G Meinel
- Institute of Diagnostic and Interventional Radiology, Paediatric Radiology and Neuroradiology, University Medical Centre Rostock, Rostock, Germany
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Böttcher B, Flatscher-Thoeni M, Geser W, Lampe A, Werner-Felmayer G, Voithofer C, Schusterschitz C. Warum Eizellen und Spermien spenden? Einstellungen und Motive von potentiellen Eizell- und Samenspendern in Österreich. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717671] [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] [Indexed: 10/23/2022] Open
Affiliation(s)
- B Böttcher
- Klinik für gyn. Endokrinologie und Reproduktionsmedizin, Medizinische Universität Innsbruck
| | - M Flatscher-Thoeni
- Department of Public Health, Health Services Research and Health Technology Assessment, UMIT – University for Health Sciences
| | - W Geser
- Institute of Psychology, Universität Innsbruck
| | - A Lampe
- University Clinic of Medical Psychology, Medizinische Universität Innsbruck
| | - G Werner-Felmayer
- Division of Biological Chemistry, Biocentre, Medizinische Universität Innsbruck
| | - C Voithofer
- Department of Civil Law, Universität Innsbruck
| | - C Schusterschitz
- Department of Psychology and Medical Sciences, UMIT – University for Health Sciences, Medical Informatics and Technology
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10
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Feil K, Böttcher B, Winkler-Crepaz K, AL Z, EM B, Toth B. Einfluss einer gegengeschlechtlicher Hormontherapie auf Laborprofil und BMI bei Trans*Personen. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717673] [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] [Indexed: 10/23/2022] Open
Affiliation(s)
- K Feil
- Medizinische Universität Innsbruck, Universitätsklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin
| | - B Böttcher
- Medizinische Universität Innsbruck, Universitätsklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin
| | - K Winkler-Crepaz
- Paracelsus Medizinische Privatuniversität Salzburg, Universitätsklinik für Frauenheilkunde und Geburtshilfe
| | - Zippl AL
- Medizinische Universität Innsbruck, Universitätsklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin
| | - Bürstmayr EM
- Medizinische Universität Innsbruck, Universitätsklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin
| | - B Toth
- Medizinische Universität Innsbruck, Universitätsklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin
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Böttcher B, Beller E, Busse A, Cantré D, Yücel S, Öner A, Ince H, Weber MA, Meinel FG. Fully automated quantification of left ventricular volumes and function in cardiac MRI: clinical evaluation of a deep learning-based algorithm. Int J Cardiovasc Imaging 2020; 36:2239-2247. [PMID: 32677023 PMCID: PMC7568707 DOI: 10.1007/s10554-020-01935-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/06/2020] [Indexed: 12/18/2022]
Abstract
To investigate the performance of a deep learning-based algorithm for fully automated quantification of left ventricular (LV) volumes and function in cardiac MRI. We retrospectively analysed MR examinations of 50 patients (74% men, median age 57 years). The most common indications were known or suspected ischemic heart disease, cardiomyopathies or myocarditis. Fully automated analysis of LV volumes and function was performed using a deep learning-based algorithm. The analysis was subsequently corrected by a senior cardiovascular radiologist. Manual volumetric analysis was performed by two radiology trainees. Volumetric results were compared using Bland–Altman statistics and intra-class correlation coefficient. The frequency of clinically relevant differences was analysed using re-classification rates. The fully automated volumetric analysis was completed in a median of 8 s. With expert review and corrections, the analysis required a median of 110 s. Median time required for manual analysis was 3.5 min for a cardiovascular imaging fellow and 9 min for a radiology resident (p < 0.0001 for all comparisons). The correlation between fully automated results and expert-corrected results was very strong with intra-class correlation coefficients of 0.998 for end-diastolic volume, 0.997 for end-systolic volume, 0.899 for stroke volume, 0.972 for ejection fraction and 0.991 for myocardial mass (all p < 0.001). Clinically meaningful differences between fully automated and expert corrected results occurred in 18% of cases, comparable to the rate between the two manual readers (20%). Deep learning-based fully automated analysis of LV volumes and function is feasible, time-efficient and highly accurate. Clinically relevant corrections are required in a minority of cases.
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Affiliation(s)
- Benjamin Böttcher
- Institute of Diagnostic and Interventional Radiology, Paediatric Radiology and Neuroradiology, University Medical Centre Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany
| | - Ebba Beller
- Institute of Diagnostic and Interventional Radiology, Paediatric Radiology and Neuroradiology, University Medical Centre Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany
| | - Anke Busse
- Institute of Diagnostic and Interventional Radiology, Paediatric Radiology and Neuroradiology, University Medical Centre Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany
| | - Daniel Cantré
- Institute of Diagnostic and Interventional Radiology, Paediatric Radiology and Neuroradiology, University Medical Centre Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany
| | - Seyrani Yücel
- Department of Internal Medicine, Divison of Cardiology, University Medical Center Rostock, Rostock, Germany
| | - Alper Öner
- Department of Internal Medicine, Divison of Cardiology, University Medical Center Rostock, Rostock, Germany
| | - Hüseyin Ince
- Department of Internal Medicine, Divison of Cardiology, University Medical Center Rostock, Rostock, Germany
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, Paediatric Radiology and Neuroradiology, University Medical Centre Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany
| | - Felix G Meinel
- Institute of Diagnostic and Interventional Radiology, Paediatric Radiology and Neuroradiology, University Medical Centre Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany.
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Böttcher B, Feil K, Winkler-Crepaz K, Zippl AL, Bürstmayr EM, Toth B. Einfluss gegengeschlechtlicher Hormontherapie bei Trans*Personen auf Laborprofil und BMI. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713187] [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] [Indexed: 10/24/2022] Open
Affiliation(s)
- B Böttcher
- Universitätsklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin, Medizinische Universität Innsbruck
| | - K Feil
- Universitätsklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin, Medizinische Universität Innsbruck
| | - K Winkler-Crepaz
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Paracelsus Medizinischen Privatuniversität Salzburg
| | - A L Zippl
- Universitätsklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin, Medizinische Universität Innsbruck
| | - E M Bürstmayr
- Universitätsklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin, Medizinische Universität Innsbruck
| | - B Toth
- Universitätsklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin, Medizinische Universität Innsbruck
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13
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Böttcher B, Kyprianou A, Lechner C, Kößler M, Heinz-Erian E, Neururer S, Abdel Azim S, Wildt L, Toth B, Baumann M, Rauchenzauner M, Rostásy K. Manifestation of migraine in adolescents: Does it change in puberty? Eur J Paediatr Neurol 2020; 26:29-33. [PMID: 32115367 DOI: 10.1016/j.ejpn.2020.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 02/07/2020] [Accepted: 02/13/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE To analyze the association between pubertal stage, menstrual cycle and migraine attacks in girls with migraine. In addition, headache frequency, accompanying symptoms, duration and onset in relation to the specific phase of the cycle were investigated. METHODS Girls between 7 and 18 years old, diagnosed with headaches that met "International Classification of Headache Disorders II" diagnostic criteria for migraine without aura, kept a daily headache and menstrual cycle diary over 8 weeks. Ovulatory cycles were identified by weekly progesterone saliva tests. RESULTS 47 girls participated in the study and were divided into three groups according to Tanner stage and onset of regular menstruation: pre- (n = 16), peri- (n = 19) and post-pubertal (n = 12). A significant difference in migraine frequency was found between pre- and post-pubertal girls (p = 0.005). No significant differences with regard to headache characteristics were detected. Interestingly, a higher frequency of attacks in follicular phase occurred compared to luteal phase in peri- and post-pubertal girls (p = 0.030). CONCLUSION During puberty, migraine patterns in girls change to a typical adult pattern of migraine in a stepwise manner not clearly related to menarche. The first sign of this transition phase could be the higher frequency of migraine attacks in post-pubertal girls.
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Affiliation(s)
- B Böttcher
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Austria.
| | - A Kyprianou
- Department of Pediatric Neurology, Children's Hospital Datteln, University of Witten Herdecke, Germany
| | - C Lechner
- Division of Pediatric Neurology, Department of Pediatrics I, Medical University of Innsbruck, Austria
| | - M Kößler
- Division of Pediatric Neurology, Department of Pediatrics I, Medical University of Innsbruck, Austria
| | - E Heinz-Erian
- Division of Pediatric Neurology, Department of Pediatrics I, Medical University of Innsbruck, Austria
| | - S Neururer
- Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Austria
| | - S Abdel Azim
- Department of Gynecology and Obstetrics, Medical University of Innsbruck, Innsbruck, Austria
| | - L Wildt
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Austria
| | - B Toth
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Austria
| | - M Baumann
- Division of Pediatric Neurology, Department of Pediatrics I, Medical University of Innsbruck, Austria
| | - M Rauchenzauner
- Division of Pediatric Neurology, Department of Pediatrics I, Medical University of Innsbruck, Austria; Department of Pediatrics, Hospital Ostallgäu-Kaufbeuren, Kaufbeuren, Germany
| | - K Rostásy
- Department of Pediatric Neurology, Children's Hospital Datteln, University of Witten Herdecke, Germany
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Flatscher-Thöni M, Böttcher B, Geser W, Lampe A, Werner-Felmayer G, Voithofer C, Schusterschitz C. Worlds apart or two sides of the same coin? Attitudes, meanings, and motives of potential oocyte and sperm donors in Austria. J Assist Reprod Genet 2020; 37:287-296. [PMID: 31916077 PMCID: PMC7056682 DOI: 10.1007/s10815-019-01683-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 12/27/2019] [Indexed: 11/29/2022] Open
Abstract
Purpose Gamete donors and recipients of such donations have been explored by previous studies, which mostly focus on post-donation scenarios. Our study analyses the general willingness to donate oocytes or sperm and focuses on differences between potential female and male donors in attitudes, meanings, and motives in a pre-donation setting. Methods An electronic survey (n = 555 students) was used in this anonymous observational study. To enable comparisons between men and women regarding their attitudes, meanings, and motives and their willingness to donate gametes, we designed two separate questionnaires. Results The sample was divided into three groups based on the willingness to donate: potential donors (n = 133; women: 48.1%, men: 51.9%); doubtful donors (n = 207; women: 75.8%, men: 24.2%); and non-donors (n = 215; women: 68.3%, men: 31.7%). The group of potential male donors (39.2%) was significantly larger than the group of potential female donors (16.9%). Significant differences regarding altruism, the meaning of one’s self-worth, and passing on the own genes were found between doubtful and potential donors. Potential donors attached less value to altruism but more value to the enhancement of one’s self-worth and passing on one’s genes than doubtful donors. The motive of passing on one’s genes and altruistic motives were more important to men than to women. Conclusion This study helps to create a better understanding of potential donors in the existing donation framework and supports the evaluation of the given regimes in the context of designing an improved framework.
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Affiliation(s)
- M Flatscher-Thöni
- Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, 6060, Hall in Tyrol, Austria
| | - B Böttcher
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
| | - W Geser
- Institute of Psychology, University of Innsbruck, 6020, Innsbruck, Austria
| | - A Lampe
- University Clinic of Medical Psychology, Medical University of Innsbruck, 6020, Innsbruck, Austria
| | - G Werner-Felmayer
- Division of Biological Chemistry, Biocentre, Medical University of Innsbruck, bioethics network education, 6020, Innsbruck, Austria
| | - C Voithofer
- Department of Civil Law, University of Innsbruck, 6020, Innsbruck, Austria
| | - C Schusterschitz
- Department of Psychology and Medical Sciences, UMIT - University for Health Sciences, Medical Informatics and Technology, 6060, Hall in Tyrol, Austria
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15
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Böttcher B, Abdel Azim S. Beyond the scope of the HPV triage strategy – proposals for consideration. BJOG 2020; 127:69. [PMID: 31605653 PMCID: PMC6916551 DOI: 10.1111/1471-0528.15983] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 10/02/2019] [Accepted: 10/08/2019] [Indexed: 11/27/2022]
Affiliation(s)
- B Böttcher
- Department of Gynaecological Endocrinology and Reproductive Medicine Medical University of Innsbruck Innsbruck Austria
| | - S Abdel Azim
- Department of Gynaecology and Obstetrics Medical University of Innsbruck Innsbruck Austria
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16
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Knobe M, Böttcher B, Coburn M, Friess T, Bollheimer LC, Heppner HJ, Werner CJ, Bach JP, Wollgarten M, Poßelt S, Bliemel C, Bücking B. [Geriatric Trauma Center DGU®: Evaluation of clinical and economic parameters : A pilot study in a german university hospital]. Unfallchirurg 2019; 122:134-146. [PMID: 29675629 DOI: 10.1007/s00113-018-0502-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Previous studies on orthogeriatric models of care suggest that there is substantial variability in how geriatric care is integrated in the patient management and the necessary intensity of geriatric involvement is questionable. OBJECTIVE The aim of the current prospective cohort study was the clinical and economic evaluation of fragility fracture treatment pathways before and after the implementation of a geriatric trauma center in conformity with the guidelines of the German Trauma Society (DGU). METHODS A comparison of three different treatment models (6 months each) was performed: A: Standard treatment in Orthopaedic Trauma; B: Special care pathways with improvement of the quality management system and implementation of standard operating procedures; C: Interdisciplinary treatment with care pathways and collaboration with geriatricians (ward round model). RESULTS In the 151 examined patients (m/w 47/104; 83.5 (70-100) years; A: n = 64, B: n = 44, C: n = 43) pathways with orthogeriatric comanagement (C) improved frequency of postoperative mobilization (p = 0.021), frequency of osteoporosis prophylaxis (p = 0.001) and the discharge procedure (p = 0.024). In comparison to standard treatment (A), orthogeriatric comanagement (C) was associated with lower rates of mortality (9% vs. 2%; p = 0.147) and cardio-respiratory complications (39% vs. 28%; p = 0.235) by trend. In this context, there were low rates of myocardial infarction (6% vs. 0%), dehydration (6% vs. 0%), cardiac dysrhythmia (8% vs. 0%), pulmonary decompensation (28% vs. 16%), electrolyt dysbalance (34% vs. 19%) and pulmonary edema (11% vs. 2%). Duration of stay in an intensive care unit was 29 h (A) and 18 h (C) respectively (p = 0.205), with consecutive reduction in costs. A sole establishment of a special care pathway for older hip fracture patients (B) showed a lower rate of myocardial infarction (A: 11%, B: 0%, C: 0%; p = 0.035). CONCLUSION There was a clear tendency to a better overall result in patients receiving multidisciplinary orthogeriatric treatment using a ward visit model of orthogeriatric comanagement, with lower rates of cardiorespiratory complications and mortality. While special care pathways could reduce the rate of myocardial infarction in hip fracture patients, costs and revenues showed no difference between all care models evaluated. However, patients with hip fracture or periprosthetic fracture represent cohorts at clinical and economic risk as well.
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Affiliation(s)
- M Knobe
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
| | - B Böttcher
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - M Coburn
- Klinik für Anästhesiologie, Uniklinik RWTH Aachen, Aachen, Deutschland
| | - T Friess
- Klinik für Unfall- und Handchirurgie, Zentrum für Alterstraumatologie im St. Clemens-Hospital Oberhausen, Oberhausen, Deutschland
| | - L C Bollheimer
- Lehrstuhl für Altersmedizin, RWTH Aachen mit Klinik für Innere Medizin und Geriatrie am Franziskushospital Aachen, Aachen, Deutschland
| | - H J Heppner
- Geriatrische Klinik und Tagesklinik, Lehrstuhl für Geriatrie, Universität Witten/Herdecke, Witten, Deutschland
| | - C J Werner
- Klinik für Neurologie, Sektion Interdisziplinäre Geriatrie, Uniklinik RWTH Aachen, Aachen, Deutschland
| | - J-P Bach
- Klinik für Neurologie, Sektion Interdisziplinäre Geriatrie, Uniklinik RWTH Aachen, Aachen, Deutschland
| | - M Wollgarten
- Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - S Poßelt
- Kaufmännisches Controlling, Uniklinik RWTH Aachen, Aachen, Deutschland
| | - C Bliemel
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Marburg, Deutschland
| | - B Bücking
- Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Marburg, Deutschland
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Toth B, Rank A, Böttcher B, Ludwig M. Thrombophilie und Alter – wann ist eine Hormontherapie in der Postmenopause trotzdem möglich? Gynäkologische Endokrinologie 2019. [DOI: 10.1007/s10304-019-0265-8] [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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18
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Toth B, Vomstein K, Togawa R, Böttcher B, Hudalla H, Strowitzki T, Daniel V, Kuon RJ. The impact of previous live births on peripheral and uterine natural killer cells in patients with recurrent miscarriage. Reprod Biol Endocrinol 2019; 17:72. [PMID: 31472670 PMCID: PMC6717647 DOI: 10.1186/s12958-019-0514-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 08/16/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Peripheral and uterine natural killer cells (pNK and uNK cells) are key players in the establishment and maintenance of pregnancy and are disturbed in patients with recurrent miscarriage (RM). Different immunologic risk factors have been proposed between patients with primary RM (pRM, no previous live birth) and secondary RM (sRM, ≥ 1 previous live birth). However, so far, the study populations mainly consisted of small subgroups. Therefore, we aimed to analyse pNK and uNK cells in a large, well defined study population within a prospective study. METHODS In total, n = 575 RM patients (n = 393 pRM, n = 182 sRM) were screened according to a standard protocol for established risk factors as well as pNK and uNK cells. Peripheral blood levels of CD45+CD3-CD56+CD16+ NK cells were determined by flow cytometry and uterine CD56+ NK cells by immunohistochemistry in mid-luteal non-pregnant RM patients. Exclusion of patients with ≥1 established risk factor revealed n = 248 idiopathic RM patients (iRM, n = 167 primary iRM (ipRM), n = 81 secondary iRM (isRM)). RESULTS Patients with pRM and ipRM showed significant higher absolute numbers and percentages of pNK cells compared to sRM and isRM patients (pRM/ipRM vs sRM/isRM, mean ± SD /μl: 239.1 ± 118.7/244.9 ± 112.9 vs 205.1 ± 107.9/206.0 ± 105.6, p = 0.004/ p = 0.009; mean ± SD %: 12.4 ± 5.5/12.8 ± 5.4 vs 11.1 ± 4.6/11.1 ± 4.3, p = 0.001; p = 0.002). Only patients with isRM showed significantly higher uNK levels compared to patients with ipRM (mean ± SD /mm2 288.4 ± 239.3 vs 218.2 ± 184.5, p = 0.044). CONCLUSIONS The demonstrated differences in pNK and uNK cells in RM patients depending on previous live birth might indicate differences in NK cell recruitment and potentially different underlying immune disorders between pRM and sRM. As there is an overlap in the distribution of the NK cell results, further studies with focus on NK cell function are needed in order to clearly identify RM patients with distinct immune abnormalities. The clinical relevance of our findings should be interpreted cautiously until specificity and sensitivity are further evaluated.
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Affiliation(s)
- B Toth
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - K Vomstein
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
- Department of Gynecological Endocrinology and Fertility Disorders, Ruprecht-Karls University Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
| | - R Togawa
- Department of Gynecological Endocrinology and Fertility Disorders, Ruprecht-Karls University Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - B Böttcher
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - H Hudalla
- Department of Neonatology, Heidelberg University Children's Hospital, Im Neuenheimer Feld 430, 69120, Heidelberg, Germany
| | - Th Strowitzki
- Department of Gynecological Endocrinology and Fertility Disorders, Ruprecht-Karls University Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - V Daniel
- Transplantation-Immunology, Institute of Immunology, Ruprecht-Karls University Heidelberg, Im Neuenheimer Feld 672, 69120, Heidelberg, Germany
| | - R J Kuon
- Department of Gynecological Endocrinology and Fertility Disorders, Ruprecht-Karls University Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
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Alrumi N, Aghaalkurdi M, Habib H, Abed S, Böttcher B. Infection control measures in neonatal units: implementation of change in the Gaza-Strip. J Matern Fetal Neonatal Med 2019; 33:3490-3496. [PMID: 30691321 DOI: 10.1080/14767058.2019.1576168] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Introduction: Low-income countries rarely report infection control measures although they are key to reducing mortality and morbidity in healthcare. This audit examined healthcare personnel's adherence to infection control measures before entry to the NICU and in both minor and major procedures' bundles. Furthermore, it examined the effect of subsequent authorization and dissemination of infection control guidelines followed by education and training sessions on the adherence of healthcare personnel to infection control policies.Methods: This prospective observational study was conducted in two NICUs at two separate hospitals in the Gaza-Strip, Palestine. The initial observation period was June-August 2016 during which healthcare professionals' adherence to infection control policies was assessed by direct observation. This was followed by NICU feedback dissemination and on-site educational and training sessions. Then, the reaudit, following the same protocol, was carried out throughout February 2017.Results: There was a statistically significant improvement in the adherence to infection control measures among healthcare personnel. Significant improvements were found in both minor and major procedure infection control protocols' adherence rates. However, when comparing the general neonatal handling adherence rate between both audits, no significant change was noted.Discussion: This study highlights the effectiveness of using audit feedback and on-site educational and training sessions in the enhancement of adherence to infection control policies, demonstrating significant improvement in areas covered by the staff training program. Therefore, including regular infection control training combined with feedback in the curriculum of healthcare professionals can improve the sustainability of infection control programs. Further studies must examine the impact of such training also on the incidence of healthcare-associated infection rates as well as morbidity and mortality within neonatal units.
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Affiliation(s)
- N Alrumi
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestinian Territories
| | - M Aghaalkurdi
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestinian Territories
| | - H Habib
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestinian Territories
| | - S Abed
- Al Nassr Pediatric Hospital, Gaza, Palestinian Territories
| | - B Böttcher
- Evidence Based Medicine Unit, Faculty of Medicine, Islamic University of Gaza, Gaza, Palestinian Territories
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Geiser M, Schick M, Wischmann T, Toth B, Böttcher B. Reziproke Wirkungen von Endometriose, Kinderwunsch und Partnerschaft bei Patientinnen und Partnern. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1678375] [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] [Indexed: 10/27/2022] Open
Affiliation(s)
- M Geiser
- Klinik für gynäkologische Endokrinologie und Reproduktionsmedizin, Medizinische Universität Innsbruck (MUI), Österreich
| | - M Schick
- Institut für Medizinische Psychologie im Zentrum für Psychosoziale Medizin (ZPM), Universitätsklinikum Heidelberg
| | - T Wischmann
- Institut für Medizinische Psychologie im Zentrum für Psychosoziale Medizin (ZPM), Universitätsklinikum Heidelberg
| | - B Toth
- Klinik für gynäkologische Endokrinologie und Reproduktionsmedizin, Medizinische Universität Innsbruck (MUI), Österreich
| | - B Böttcher
- Klinik für gynäkologische Endokrinologie und Reproduktionsmedizin, Medizinische Universität Innsbruck (MUI), Österreich
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21
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Feigl S, Wegscheider J, Feil K, Winkler-Crepaz K, Böttcher B, Toth B. Evaluation der Lebensqualität von Trans*Personen unter gegengeschlechtlicher Hormontherapie. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1670975] [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] [Indexed: 10/28/2022] Open
Affiliation(s)
- S Feigl
- Universitätsklinik für Gynäkologische Endokrinologie u. Reproduktionsmedizin, Innsbruck, Österreich
| | - J Wegscheider
- Universitätsklinik für Gynäkologische Endokrinologie u. Reproduktionsmedizin, Innsbruck, Österreich
| | - K Feil
- Universitätsklinik für Gynäkologische Endokrinologie u. Reproduktionsmedizin, Innsbruck, Österreich
| | - K Winkler-Crepaz
- Universitätsklinik für Gynäkologische Endokrinologie u. Reproduktionsmedizin, Innsbruck, Österreich
| | - B Böttcher
- Universitätsklinik für Gynäkologische Endokrinologie u. Reproduktionsmedizin, Innsbruck, Österreich
| | - B Toth
- Universitätsklinik für Gynäkologische Endokrinologie u. Reproduktionsmedizin, Innsbruck, Österreich
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Böttcher B, Fessler S, Friedl F, Toth B, Walter MH, Wildt L, Riedl D. Health-related quality of life in patients with polycystic ovary syndrome: validation of the German PCOSQ-G. Arch Gynecol Obstet 2018; 297:1027-1035. [PMID: 29249009 PMCID: PMC5849657 DOI: 10.1007/s00404-017-4623-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 12/06/2017] [Indexed: 02/07/2023]
Abstract
PURPOSE Patients with polycystic ovary syndrome (PCOS) report a decreased health-related quality of life (HRQOL) and higher levels of psychological distress. Validated questionnaires are necessary to assess the impact of PCOS on patients' lives. The aim of the present study was to evaluate the German "Polycystic Ovary Syndrome Questionnaire" (PCOSQ-G). METHODS The psychometric properties of the PCOSQ-G were investigated in PCOS patients with item-total correlation, internal consistency and test-retest reliability. Correlations with the Short-Form-36 Health Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS-D) were calculated to evaluate the validity of the PCOSQ-G. Discriminatory validity was investigated through a receiver operating characteristic curve and independent sample t tests compared with healthy controls. RESULTS Good psychometric properties were found for most items. Acceptable to high internal consistency was found for the total score (α = 0.94-0.95) and all subscales (α = 0.70-0.97). High test-retest reliability was found for the total score (0.86) and all subscales (0.81-0.90). The validity analyses showed that the PCOSQ-G total score was positively correlated with both SF-36 summary scales and was negatively correlated with both HADS subscales. Patients reported significantly lower values for the PCOSQ-G total score (p < 0.001) and all subscales, and the PCOSQ-G discriminated well between patients and healthy controls (AUC = 0.81, p < 0.001). CONCLUSIONS PCOSQ-G is a reliable and valid tool to assess the HRQOL in patients with PCOS and can be used in future clinical research. Patients with PCOS exhibited an impaired HRQOL, which indicates the need for psychosomatic counseling.
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Affiliation(s)
- B Böttcher
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - S Fessler
- Department of Psychology, University of Innsbruck, Bruno-Sander-Haus, Innrain 52f, 6020, Innsbruck, Austria
| | - F Friedl
- Department of Psychology, University of Innsbruck, Bruno-Sander-Haus, Innrain 52f, 6020, Innsbruck, Austria
| | - B Toth
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - M H Walter
- Department of Psychology, University of Innsbruck, Bruno-Sander-Haus, Innrain 52f, 6020, Innsbruck, Austria
| | - L Wildt
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - D Riedl
- University Clinic of Medical Psychology, Medical University Innsbruck, Schöpfstr. 23a, 6020, Innsbruck, Austria.
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Fischer T, Böttcher B, Mraheel S, Scharl A, Gabruk-Szostak B, Scheidhauer K, Göhring UJ, Meller-Rehbein B, Shukla SK, Schicha H, Schomäcker K. Die Kinetik von rezeptorvermittelter Radiotoxizität des 16α-[125I]-Iodöstradiol-3,17ß. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1632313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Zusammenfassung
Ziel: Es wurden radiozytotoxische Effekte von 16α-[125l]-lodöstradi- ol-3,17ß ü
125
I]E) an MCF-7-Mammakarzinom-Zellen in Abhängigkeit von der Inkubationszeit in dem Zeitraum zwischen 1 und 24 h untersucht. Methoden: Der Rezeptorstatus der Zellen wurde durch immunhisto- chemische Färbung bestimmt. Die Akkumulation von [125|]E wurde in Gegenwart und Abwesenheit von nichtradioaktivem Östradiol sowie [127I]E und in Östrogenrezeptor (ER)-negativen im Vergleich zu ER-positiven Zellen getestet. Die Ermittlung der subzellulären Verteilung erfolgte in 0,25 M Saccharose durch Ultrazentrifugation. Die Radiozytotoxizität wurde unter den verschiedenen Versuchsbedingungen durch Standard- Kolonie-Assays nach Inkubation mit [125I]E (1.85 kBq/ml-55.5 kBq/ml) für 1, 2, 4, 8, 12 und 24 h ermittelt. Ergebnisse: Eine deutliche Zytotoxizität wurde nur bei Inkubation ER-positiver Zellen mit [125I]E gefunden. Das Maximum lag bei einer Reduktion der Überlebensfraktion auf 20-25% bei Radioaktivitätskonzentrationen im Inkubationsmedium von >37 kBq/ml. Diese maximalen Effekte wurden nach Inkubationszeiten von 8 h gefunden. Eine Verlängerung der Inkubationszeit führte zu keiner weiteren Verstärkung der Toxizität. Schlußfolgerungen: Die Ergebnisse zeigen, daß die Radioaktivität an die Östrogenrezeptoren gebunden wurde. Infolge ihrer Kernlokalisation haben Radioöstrogene, die sehr niederenergetische Elektronen (Auger-Elektronen) emittieren, therapeutische Relevanz durch ER-vermittelte Entfaltung zellinaktivierender, ionisierender Strahlung ohne Beeinflussung benachbarter Zellen. Allerdings sollte anstelle von 125l das kürzerlebige 123l zur Markierung zum Einsatz kommen, da die entscheidenden Strahleneffekte innerhalb von 8 h erfolgen.
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Böttcher B, Wildt L. Autoimmunerkrankungen und orale Kontrazeption. Gynäkologische Endokrinologie 2017. [DOI: 10.1007/s10304-017-0148-9] [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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Elshami M, Alaloul E, Khader E, Awad I, Alhelu A, Baraka H, Abu Nemer H, Böttcher B, Elessi K. Impact of mastectomy on the social well-being and family dynamics of breast cancer female patients in the Gaza Strip. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx385.014] [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: 11/13/2022] Open
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Winkler-Crepaz K, Müller A, Böttcher B, Wildt L. Hormonbehandlung bei Transgenderpatienten. Gynäkologische Endokrinologie 2017. [DOI: 10.1007/s10304-016-0116-9] [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: 10/20/2022]
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Kolben TM, Bergauer F, Moeckel J, Böttcher B, Thaler C, Crispin A, Kolben T, Dannecker C, Mahner S, Gallwas J. Does a short interval between two pap smears significantly affect the result of the second smear? Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593054] [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: 10/20/2022] Open
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Böttcher B, Siedentopf C, Steiger R, Verius M, Riedl D, Schmid J, Elsenbruch S, Wildt L, Gizewski E. Schmerzaktivierung bei Patientinnen mit Dysmenorrhoe – Ergebnisse einer fMRT-Studie. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593078] [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: 10/20/2022] Open
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Böttcher B, Wildt L. Nichtklassisches adrenogenitales Syndrom. Gynäkologische Endokrinologie 2016. [DOI: 10.1007/s10304-016-0088-9] [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: 11/28/2022]
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Böttcher B, Siedentopf C, Kurz S, Riedl D, Gizewski ER, Wildt L. Angst und Depression bei Patientinnen mit Dysmenorrhoe-Daten aus einer fMRT-Studie. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1582171] [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: 10/21/2022] Open
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Böttcher B. Ausgewählte Aspekte zyklusabhängiger Erkrankungen. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0035-1570042] [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: 10/22/2022] Open
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Stoettner B, Ziehr S, Wildt L, Böttcher B. Transgender – Die Behandlung an der Universitätsklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin Innsbruck. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1555024] [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: 10/23/2022] Open
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Leyendecker G, Bilgicyildirim A, Inacker M, Stalf T, Huppert P, Mall G, Böttcher B, Wildt L. Adenomyosis and endometriosis. Re-visiting their association and further insights into the mechanisms of auto-traumatisation. An MRI study. Arch Gynecol Obstet 2015; 291:917-32. [PMID: 25241270 PMCID: PMC4355446 DOI: 10.1007/s00404-014-3437-8] [Citation(s) in RCA: 137] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 08/25/2014] [Indexed: 01/24/2023]
Abstract
PURPOSE In a series of publications, we had developed the concept that uterine adenomyosis and pelvic endometriosis as well as endometriotic lesions at distant sites of the body share a common pathophysiology with endometriosis constituting a secondary phenomenon. Uterine auto-traumatization and the initiation of the mechanism of tissue injury and repair (TIAR) were considered the primary events in the disease process. The present MRI study was undertaken (1) to corroborate this concept by re-visiting, in view of discrepant results in the literature, the association of adenomyosis with endometriosis and (2) to extend our views concerning the mechanisms of uterine auto-traumatization. PATIENTS AND METHODS MRI was performed in 143 women attending our center, in whom, on the basis of transvaginal sonography (TVS) and historical data, such as documented endometriosis and dysmenorrhea of various degrees of severity, the presence of uterine adenomyosis was suspected. In addition to the measurement of the diameter of junctional zone (JZ) of the anterior and posterior walls in the mid-sagittal plane, the diagnosis of adenomyosis was based on visualization, in that all planes were analyzed with scrutiny. By this method of "visualization" all transient enlargement of the JZ, such as peristaltic waves of the archimyometrium and sporadic neometral contractions that might mimic adenomyotic lesions could be excluded. At the same time, this method allowed to lower the limit of detection in terms of thickness of the JZ for assured diagnosis of adenomyosis. Furthermore, the localizations of the individual lesions, their shapes and patterns were described. RESULTS With the method of 'visualization', the diagnosis of uterine adenomyosis could be verified in 127 of the 143 patients studied. The prevalence of endometriosis in adenomyosis was 80.6% and the prevalence of adenomyosis in endometriosis was 91.1%. As concluded from their localization within the uterine wall, the adenomyotic lesions predominantly developed in the median region of the upper two-thirds of the uterine wall. Cystic cornual angle adenomyosis was a distinct phenomenon that was only observed in patients suffering from extreme primary dysmenorrhea. Aside from this, the majority of the patients complained of primary dysmenorrhea (80%). On the basis of these findings and the fact that particularly extreme primary dysmenorrhea is associated with high intrauterine pressure, menstrual 'archimetral compression by neometral contraction' has to be considered as an important cause of uterine auto-traumatization in addition to uterine peristalsis and hyperperistalsis. Both mechanical functions of the non-pregnant uterus exert their strongest power in the upper region of the uterus, which is compatible with the predominant localization of the adenomyotic lesions. CONCLUSIONS The data confirm our previous results of a high association of adenomyosis with endometriosis and vice versa. Our view of the mechanism of uterine auto-traumatization by mechanical functions of the non-pregnant uterus has to be extended, in that 'archimetral compression by neometral contractions' could be realized as the predominant cause of mechanical strain to the non-pregnant uterus. The data of this study confirm our concept of the etiology and pathophysiology of adenomyosis and endometriosis in that the process of chronic proliferation and inflammation is induced at the level of the archimetra by chronic uterine auto-traumatization. Furthermore, with respect to the diagnosis of uterine adenomyosis (and consequently endometriosis) this study shows a high degree of accordance between the findings in real-time TVS and MRI.
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Affiliation(s)
- G Leyendecker
- Kinderwunschzentrum (Fertility Center) Darmstadt, Bratustr. 9, 64293, Darmstadt, Germany,
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Böttcher B, Dörr H, Wildt L. Naltrexone as a diagnostic tool to distinguish between hyperandrogenemic and hypothalamic ovarian failure in females with congenital adrenal hyperplasia due to 21-hydroxylase-deficiency (CAH). Eur J Obstet Gynecol Reprod Biol 2014; 180:153-6. [DOI: 10.1016/j.ejogrb.2014.06.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Revised: 06/05/2014] [Accepted: 06/13/2014] [Indexed: 11/29/2022]
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Abstract
Es werden die Darstellung und die Eigenschaften von β-Alkoxypropionsäure-Cholesterinestern beschrieben und mit denen der entsprechenden Fettsäuren verglichen. Die Schmelzpunkte nehmen mit einer steigenden Zahl von Ätherfunktionen ab. Alle untersuchten Verbindungen durchlaufen die cholesterinische Phase nur beim Abkühlen. Smektische Phasen wurden nicht beobachtet.
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Affiliation(s)
- D. Gross
- Berlin-Dahlem, Bundesanstalt für Materialprüfung
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- Berlin-Dahlem, Bundesanstalt für Materialprüfung
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Böttcher B, Wildt L. Treatment of refractory vulvovaginal pruritus with naltrexone, a specific opiate antagonist. Eur J Obstet Gynecol Reprod Biol 2014; 174:115-6. [DOI: 10.1016/j.ejogrb.2013.12.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 09/23/2013] [Accepted: 12/03/2013] [Indexed: 11/29/2022]
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Czech T, Böttcher B, Wildt L. Jugularvenenthrombose als seltene Komplikation bei OHSS - Berichte von 2 Fällen. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1347774] [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] Open
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Böttcher B, Stahlhofer KJ, Mattle V, Seeber B, Brezinka C, Wildt L. Ultrasonographic assessment of skin thickness in patients with PCOS - a case-control study. Gynecol Endocrinol 2013; 29:380-3. [PMID: 23316887 DOI: 10.3109/09513590.2012.752453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To measure skin thickness in patients with polycystic ovary syndrome (PCOS) in comparison to controls and to examine a possible association with sex steroids, body mass index, lipid profile and hyperinsulinemia. METHODS Thirty patients with confirmed PCOS were compared to thirty-two women presenting for infertility workup. Skin thickness was measured using high-resolution ultrasound in a standardized area, blood samples were collected once at presentation. RESULTS Patients with PCOS showed a statistically significant thicker skin than women in the control group (0.95 mm (±0.093 mm) versus 0.85 mm (±0.077 mm, p < 0.0001)). LH, estradiol, testosterone, the free androgen index, triglycerides, cholesterol, LDL-cholesterol and body mass index were significantly increased in PCOS - patients. No correlation between hyperinsulinemia and skin thickness was seen. CONCLUSIONS PCOS - patients showed a greater skin thickness in comparison to women without PCOS. This might be due to proliferative effects of sex steroids such as estrogens and testosterone and metabolic derangements on skin thickness.
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Affiliation(s)
- B Böttcher
- Department of Gynecological Endocrinology and Reproductive Medicine, Innsbruck Medical University, Innsbruck, Austria
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Tews I, Guédez G, Windeisen V, Sinning I, Hipp K, Böttcher B, Gengenbacher M, Derrer B, Kappes B. Malarial vitamin B6 biosynthesis. Acta Crystallogr A 2012. [DOI: 10.1107/s0108767312099382] [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: 11/11/2022] Open
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Böttcher B, Radenbach K, Wildt L, Hinney B. Hormonal contraception and depression: a survey of the present state of knowledge. Arch Gynecol Obstet 2012; 286:231-6. [DOI: 10.1007/s00404-012-2298-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 03/13/2012] [Indexed: 10/28/2022]
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Winkler K, Böttcher B, Czech T, Brezinka C, Widschwendter A, Maier H, Wildt L. Bilaterale Leydig-Zell-Hyperplasie der Ovarien – Ein Fallbericht. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1278586] [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: 10/18/2022] Open
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Böttcher B, Götsch C, Brezinka C, Wildt L. Hypoparathyreoidismus in der Schwangerschaft. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1278580] [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: 10/18/2022] Open
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Böttcher B, Schmidts V, Raskatov J, Thiele C. Bestimmung der Konformation des Schlüsselintermediats einer enantioselektiven Palladium-katalysierten allylischen Substitution mithilfe dipolarer Restkopplungen. Angew Chem Int Ed Engl 2009. [DOI: 10.1002/ange.200903649] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Böttcher B, Schmidts V, Raskatov J, Thiele C. Determination of the Conformation of the Key Intermediate in an Enantioselective Palladium-Catalyzed Allylic Substitution from Residual Dipolar Couplings. Angew Chem Int Ed Engl 2009; 49:205-9. [DOI: 10.1002/anie.200903649] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Thiele C, Schmidts V, Böttcher B, Louzao I, Berger R, Maliniak A, Stevensson B. On the Treatment of Conformational Flexibility when Using Residual Dipolar Couplings for Structure Determination. Angew Chem Int Ed Engl 2009; 48:6708-12. [DOI: 10.1002/anie.200902398] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Thiele C, Schmidts V, Böttcher B, Louzao I, Berger R, Maliniak A, Stevensson B. On the Treatment of Conformational Flexibility when Using Residual Dipolar Couplings for Structure Determination. Angew Chem Int Ed Engl 2009. [DOI: 10.1002/ange.200902398] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Pfeil A, Hädrich C, Gruhn B, Böttcher B, Kentouche K, Mentzel HJ, Kaiser WA. Evaluierung der Knochenmineraldichte bei Kindern und Jugendlichen nach Stammzelltransplantation durch die peripher messende Digitale Radiogrammetrie. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073980] [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: 10/21/2022]
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Pfeil A, Böttcher B, Seidl BE, Heyne JP, Schmidt M, Schäfer ML, Petrovitch A, Kaiser WA. Computer-assistierte Gelenkspaltweitenmessung (CAJSA) der Distalen Interphalangeal – Gelenke. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-977351] [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: 10/21/2022]
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Pfeil A, Böttcher B, Seidl BE, Schäfer ML, Schmidt M, Petrovitch A, Heyne JP, Hansch A, Kaiser WA. Alters- und geschlechtsspezifische Quantifizierung der Gelenkspaltweite der Metakarpo-Phalangeal Gelenke mittels Computer-assistierter Gelenkspaltweitenmessung. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-977279] [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: 10/21/2022]
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