1
|
Keckstein S, Tilgener C, Jeschke U, Hofmann S, Vilsmaier T, Keilmann L, Heidegger H, Kaltofen T, Batz F, Mahner S, Schröder L. Effects of matcha tea extract on cell viability and estrogen receptor-β expression on MCF-7 breast cancer cells. Arch Gynecol Obstet 2024; 309:1509-1514. [PMID: 37737883 PMCID: PMC10894130 DOI: 10.1007/s00404-023-07209-z] [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: 06/29/2023] [Accepted: 08/28/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE In the following work, we investigated the effect of matcha green tea extract (MTE) on MCF-7 breast cancer cell viability and estrogen receptor-beta expression (ERβ). METHODS MCF-7 cells were stimulated with MTE at concentrations of 5 and 10 µg/ml. Cell viability was assessed using a water-soluble tetrazolium assay (WST-1 assay) after an incubation time of 72 h. ERβ was quantified at gene level by real-time polymerase chain reaction (PCR). A western blot (WB) was carried out for the qualitative assessment of the expression behavior of on a protein level. RESULTS The WST-1 test showed a significant inhibition of viability in MFC-7 cells after 72 h at 10 µg/ml. The WB demonstrated a significant quantitative decrease of ERβ at protein level with MTE concentrations of 10 µg/ml. In contrast, the PCR did not result in significant downregulation of ERβ. CONCLUSION MTE decreases the cell viability of MCF-7 cells and furthermore leads to a decrease of ERβ at protein level.
Collapse
Affiliation(s)
- Simon Keckstein
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Constantin Tilgener
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
- Department of Urology and Transplant Surgery, Klinikum Stuttgart, Stuttgart, Germany
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
- Department of Obstetrics and Gynecology, University Hospital Augsburg, Augsburg, Germany
| | - Simone Hofmann
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Lucia Keilmann
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Helene Heidegger
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Till Kaltofen
- Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Falk Batz
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Lennard Schröder
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
| |
Collapse
|
2
|
Li P, Langer M, Vilsmaier T, Kramer M, Sciuk F, Kolbinger B, Jakob A, Rogenhofer N, Dalla-Pozza R, Thaler C, Haas NA, Oberhoffer FS. Vascular Health of Females with History of Assisted Reproductive Technology. J Cardiovasc Dev Dis 2024; 11:66. [PMID: 38392280 PMCID: PMC10889395 DOI: 10.3390/jcdd11020066] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 02/12/2024] [Indexed: 02/24/2024] Open
Abstract
The use of assisted reproductive technologies (ART) for the treatment of infertility is gaining popularity. Limited data on the overall vascular health of females with history of ART are available. This pilot study aimed to investigate the overall vascular health of females with history of ART compared to individuals who conceived spontaneously. The assessment of overall vascular health included the measurement of brachial blood pressure, central blood pressure, and pulse wave velocity, as well as the evaluation of the arterial stiffness and carotid intima-media thickness (cIMT) of the common carotid arteries. Conventional blood lipids including lipoprotein a (Lp(a)) were also determined. In total, 45 females with history of ART and 52 females who conceived spontaneously were included (mean age: 47.72 ± 5.96 years vs. 46.84 ± 7.43 years, p = 0.525). An initial comparison revealed a significantly higher prevalence of elevated Lp(a) in ART females (p = 0.011). However, after multiple comparison correction, the significant result disappeared (p = 0.132). Within the cohort of ART females, no significantly higher cardiovascular risk was detected regarding vascular function. The potentially higher prevalence of elevated Lp(a) in ART females must be further investigated in future studies, as it might contribute to the impaired reproductive process in this cohort.
Collapse
Affiliation(s)
- Pengzhu Li
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Magdalena Langer
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Theresa Vilsmaier
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Marie Kramer
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Franziska Sciuk
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Brenda Kolbinger
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, University Hospital, LMU Munich, 81377 Munich, Germany
| | - André Jakob
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Nina Rogenhofer
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Robert Dalla-Pozza
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Christian Thaler
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Nikolaus Alexander Haas
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Felix Sebastian Oberhoffer
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
| |
Collapse
|
3
|
Oberhoffer FS, Langer M, Li P, Vilsmaier T, Sciuk F, Kramer M, Kolbinger B, Jakob A, Rogenhofer N, Dalla-Pozza R, Thaler C, Haas NA. Vascular function in a cohort of children, adolescents and young adults conceived through assisted reproductive technologies-results from the Munich heARTerY-study. Transl Pediatr 2023; 12:1619-1633. [PMID: 37814707 PMCID: PMC10560362 DOI: 10.21037/tp-23-67] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/12/2023] [Indexed: 10/11/2023] Open
Abstract
Background Over 8 million individuals worldwide have been conceived through assisted reproductive technologies (ART). There is conflicting evidence on the cardiovascular health of ART offspring. This study aimed to investigate vascular function in a cohort of children, adolescents and young adults conceived through ART compared to spontaneously conceived peers. Methods Anthropometric variables, diet quality, level of physical activity and sedentary behavior were assessed. An extensive evaluation of vascular function was conducted. Blood pressure as well as endothelial function were evaluated. Carotid intima-media thickness was recorded sonographically. Blood draws were taken to determine blood lipids as well as HbA1c. Results In total, 66 ART subjects conceived through in vitro fertilization (IVF) or intracytoplasmic sperm injection and 86 spontaneously conceived peers were included in this observational cohort study. Both groups were similar in age [11.31 (8.10-18.00) vs. 11.85 (8.72-18.27) years, P=0.373]. ART subjects displayed a significantly higher body fat percentage [19.30% (15.80-26.02%) vs. 15.91% (13.21-21.00%), P=0.007]. Both groups did not differ significantly in diet quality, physical activity, sedentary behavior, and vascular function. Blood lipids and HbA1c were comparable between both groups. ART subjects showed significantly lower levels of triglycerides compared to spontaneously conceived peers. The prevalence of lipoprotein (a) [Lp(a)] ≥50 mg/dL tended to be higher within the ART cohort. Vascular function did not deteriorate more profoundly with age in ART subjects than in spontaneously conceived peers. Conclusions The results of the current study do not indicate a significantly lower vascular function in a cohort of children, adolescents and young adults conceived through ART compared to spontaneously conceived peers. Future studies should address the prevalence of elevated Lp(a) levels in infertile individuals who sought ART treatment. In addition, more studies evaluating body fat percentage as well as cardiovascular morbidity in adult ART subjects are required. For a more precise cardiovascular risk stratification, multi-center studies with larger ART sample sizes, preferably at adult age, are required in the future.
Collapse
Affiliation(s)
| | - Magdalena Langer
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Pengzhu Li
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Theresa Vilsmaier
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Germany
| | - Franziska Sciuk
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Marie Kramer
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Brenda Kolbinger
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Germany
| | - André Jakob
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Nina Rogenhofer
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Germany
| | - Robert Dalla-Pozza
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Christian Thaler
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Germany
| | - Nikolaus Alexander Haas
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| |
Collapse
|
4
|
Schneider M, Köpke MB, Zehni AZ, Vilsmaier T, Kessler M, Kailuweit M, Vattai A, Heidegger HH, Cavaillès V, Jeschke U, Ditsch N. Cytoplasmic Localization of Thyroid Hormone Receptor (TR) Alpha and Nuclear Expression of Its Isoform TRα2 Determine Survival in Breast Cancer in Opposite Ways. Cancers (Basel) 2023; 15:3610. [PMID: 37509273 PMCID: PMC10377287 DOI: 10.3390/cancers15143610] [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: 06/15/2023] [Revised: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
The aim of this retrospective study was to assess the respective prognostic values of cytoplasmic and nuclear TRα, TRα1, and TRα2 expression in breast cancer (BC) tissue samples and correlate the results with clinico-pathological parameters. In 249 BC patients, the expression patterns of general TRα and the α1 and α2 isoforms were evaluated via immuno-histochemistry. Prognosis-determining aspects were calculated via univariate, as well as multivariate, analysis. Univariate Cox-regression analysis revealed no association between nuclear TRα expression and overall survival (OS) (p = 0.126), whereas cytoplasmic TRα expression was significantly correlated with a poor outcome for both OS (p = 0.034) and ten-year survival (p = 0.009). Strengthening these results, cytoplasmic TRα was found to be an independent marker of OS (p = 0.010) when adjusted to fit clinico-pathological parameters. Analyses of the TRα-subgroups revealed that TRα1 had no prognostic relevance, whereas nuclear TRα2 expression was positively associated with OS (p = 0.014), ten-year survival (p = 0.029), and DFS (p = 0.043). Additionally, nuclear TRα2 expression was found to be an independent positive prognosticator (p = 0.030) when adjusted to fit clinico-pathological parameters. Overall, our results support the hypothesis that subcellular localization of TRα and its isoforms plays an important role in the carcinogenesis and prognosis of breast cancer. Cytoplasmic TRα expression correlates with more aggressive disease progression, whereas nuclear TRα2 expression appears to be a protective factor. These data may help us to prioritize high-risk BC subgroups for possible targeted tumor therapy.
Collapse
Affiliation(s)
- Mariella Schneider
- Department of Obstetrics and Gynecology, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Melitta B Köpke
- Department of Obstetrics and Gynecology, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Alaleh Zati Zehni
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU Munich, 81377 Munich, Germany
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU Munich, 81377 Munich, Germany
| | - Mirjana Kessler
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU Munich, 81377 Munich, Germany
| | - Magdalena Kailuweit
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU Munich, 81377 Munich, Germany
| | - Aurelia Vattai
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU Munich, 81377 Munich, Germany
| | | | - Vincent Cavaillès
- IRCM-Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université Montpellier, Parc Euromédecine, 208 rue des Apothicaires, CEDEX 5, F-34298 Montpellier, France
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital Augsburg, 86156 Augsburg, Germany
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU Munich, 81377 Munich, Germany
| | - Nina Ditsch
- Department of Obstetrics and Gynecology, University Hospital Augsburg, 86156 Augsburg, Germany
| |
Collapse
|
5
|
Sciuk F, Vilsmaier T, Kramer M, Langer M, Kolbinger B, Li P, Jakob A, Rogenhofer N, Dalla-Pozza R, Thaler C, Haas NA, Oberhoffer FS. Significantly Increased Left Ventricular Afterload in Adolescents and Young Adults Conceived through Assisted Reproductive Technologies: Insights from the Munich heARTerY Study. Thorac Cardiovasc Surg 2023. [DOI: 10.1055/s-0043-1761846] [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: 03/22/2023]
Affiliation(s)
- F. Sciuk
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Deutschland
| | - T. Vilsmaier
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Deutschland
| | - M. Kramer
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Deutschland
| | - M. Langer
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Deutschland
| | - B. Kolbinger
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Deutschland
| | - P. Li
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Deutschland
| | - A. Jakob
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Deutschland
| | - N. Rogenhofer
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Deutschland
| | - R. Dalla-Pozza
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Deutschland
| | - C. Thaler
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Deutschland
| | - N. A. Haas
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Deutschland
| | - F. S. Oberhoffer
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Deutschland
| |
Collapse
|
6
|
Sciuk F, Vilsmaier T, Kramer M, Langer M, Kolbinger B, Li P, Jakob A, Rogenhofer N, Dalla-Pozza R, Thaler C, Haas NA, Oberhoffer FS. Left ventricular systolic function in subjects conceived through assisted reproductive technologies. Front Cardiovasc Med 2023; 10:1059713. [PMID: 36937909 PMCID: PMC10017441 DOI: 10.3389/fcvm.2023.1059713] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 10/01/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
Background Over the past decades, assisted reproductive technologies (ART) have gained remarkable influence in the treatment of infertility and account for more than 2 % of births in European countries nowadays. Accumulating evidence suggests ART to cause cardiovascular alterations, including left ventricular (LV) dysfunctions, within its offspring. The aim of this study was to assess LV systolic function in subjects conceived through ART in comparison to spontaneously conceived peers. Methods For the assessment of LV morphology and LV function, M-Mode echocardiography, pulsed wave Doppler and two-dimensional speckle tracking echocardiography (2DSTE) were applied. LV ejection fraction (EF) and fractional shortening (FS) were assessed in M-Mode and calculated by Teichholz formula. EF was additionally assessed semiautomatically through 2DSTE. Results In total, 64 ART subjects and 83 spontaneously conceived controls with no significant differences in age (12.52 ± 5.64 years vs. 13.20 ± 5.95 years, p = 0.486) and sex were included in the analysis. In the ART cohort, significantly lower values were observed for M-Mode assessed EF (63.63 ± 5.17 % vs. 65.35 ± 5.10 %, p = 0.046) and FS (34.26 ± 3.87 % vs. 35.60 ± 3.84 %, p = 0.038). However, after the adjustment for birth weight percentile and gestational age, M-Mode assessed EF and FS displayed no significant differences between both groups. LV morphology and remaining systolic function parameters, such as mitral annular plane systolic excursion, aortic velocity time integral, global peak longitudinal strain and 2DSTE measured EF, were comparable between both groups. Conclusion This study suggests a lower LV systolic function in ART subjects, visualized by significantly lower values for M-Mode assessed EF and FS, compared to spontaneously conceived peers. The clinical relevance of these findings has to be investigated as the above-mentioned parameters were in normal reference range. In addition, LV systolic function parameters evaluated by other echocardiographic imaging modalities were comparable between both groups. Therefore, further studies will be required to evaluate the influence of ART on LV systolic function and cardiovascular morbidity in the future.
Collapse
Affiliation(s)
- Franziska Sciuk
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Theresa Vilsmaier
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Marie Kramer
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Magdalena Langer
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Brenda Kolbinger
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Pengzhu Li
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - André Jakob
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Nina Rogenhofer
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Robert Dalla-Pozza
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Christian Thaler
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Nikolaus Alexander Haas
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Felix Sebastian Oberhoffer
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
- *Correspondence: Felix Sebastian Oberhoffer,
| |
Collapse
|
7
|
Langer M, Vilsmaier T, Kramer M, Sciuk F, Kolbinger B, Li P, Jakob A, Rogenhofer N, Dalla-Pozza R, Thaler C, Haas NA, Oberhoffer FS. Vascular Health in Adults Born After Using Assisted Reproductive Technologies. Pediatr Cardiol 2022:10.1007/s00246-022-03050-4. [PMID: 36401124 DOI: 10.1007/s00246-022-03050-4] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 11/07/2022] [Indexed: 11/19/2022]
Abstract
An increasing number of children are conceived by assisted reproductive technologies (ART). Several studies indicated vascular alterations in ART children. However, limited data is available within the adult ART population. Therefore, this study investigated the overall vascular health of young ART adults in comparison to spontaneously conceived peers. In total, 16 ART subjects and 22 spontaneously conceived peers (22.06 ± 2.21 years vs. 22.00 ± 2.14 years, p = 0.194) were enrolled for the assessment of endothelial function, brachial blood pressure, central blood pressure, pulse wave velocity, carotid intima-media thickness, and blood lipids. No significant differences in vascular function were detected between the in vitro fertilization subgroup (n = 9), the intracytoplasmic sperm injection subgroup (n = 7) and spontaneously conceived peers. This pilot study suggests an unimpaired vascular function in young ART adults. In the future, multi-centric studies with a greater sample size are required to confirm the results of the current study and enable precise cardiovascular risk stratification of the adult ART population.
Collapse
Affiliation(s)
- Magdalena Langer
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Theresa Vilsmaier
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Marie Kramer
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Franziska Sciuk
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Brenda Kolbinger
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Pengzhu Li
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - André Jakob
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Nina Rogenhofer
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Robert Dalla-Pozza
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Christian Thaler
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Nikolaus Alexander Haas
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | | |
Collapse
|
8
|
Köpke MB, Chateau MC, Boissière-Michot F, Schneider M, Garrido F, Zati-Zehni A, Vilsmaier T, Kessler M, Ditsch N, Cavaillès V, Jeschke U. Prognostic Relevance of Nuclear Receptors in Relation to Peritumoral Inflammation and Tumor Infiltration by Lymphocytes in Breast Cancer. Cancers (Basel) 2022; 14:cancers14194561. [PMID: 36230483 PMCID: PMC9559250 DOI: 10.3390/cancers14194561] [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: 07/06/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022] Open
Abstract
The prognostic impact of tumor-infiltrating lymphocytes (TILs) is intensively investigated in breast cancer (BC). It is already known that triple-negative breast cancer (TNBC), the most aggressive type of BC, has the highest percentage of TILs. In addition, there is an influence of steroid hormone receptor expression (type I nuclear receptors) on TIL subpopulations in breast cancer tissue. The link between type II nuclear receptors and the level of TILs is unclear. Therefore, the aim of this study was to quantify TILs in a panel of 264 sporadic breast cancers and investigate the correlation of TIL levels with type I and II nuclear receptors expression. TIL levels were significantly increased in the subgroup of TNBC. By contrast, they decreased in estrogen (ER)- or progesterone receptor (PR)-positive cases. Moreover, TIL levels were correlated with type II nuclear receptors, including PPARγ, with a significant inverse correlation of the nuclear form (r = −0.727, p < 0.001) and a weak positive correlation of the cytoplasmic form (r = 0.202, p < 0.002). Surprisingly, BC cases with a TIL Salgado score of >15% showed a significantly decreased overall survival. In addition, peritumoral inflammation was also quantified in BC tissue samples. In our cohort, although the level of peritumoral inflammation was not correlated with OS, it determined the prognostic value of ER, PR, and PPARγ in BC. Altogether, the present study provides a differentiated overview of the relations between nuclear receptor expression, TIL levels, peritumoral inflammation, and prognosis in BC.
Collapse
Affiliation(s)
- Melitta B. Köpke
- Department of Obstetrics & Gynecology, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Marie-Christine Chateau
- Translational Research Unit, Montpellier Cancer Institute Val d’Aurelle, 208 rue des Apothicaires, F-34298 Montpellier, France
| | - Florence Boissière-Michot
- Translational Research Unit, Montpellier Cancer Institute Val d’Aurelle, 208 rue des Apothicaires, F-34298 Montpellier, France
| | - Mariella Schneider
- Department of Obstetrics & Gynecology, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Fabian Garrido
- Department of Obstetrics & Gynecology, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Alaleh Zati-Zehni
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Mirjana Kessler
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Nina Ditsch
- Department of Obstetrics & Gynecology, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Vincent Cavaillès
- IRCM-Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université Montpellier, Parc Euromédecine, 208 rue des Apothicaires, F-34298 Montpellier, France
- Correspondence: (V.C.); (U.J.); Tel.: +33-4-11-28-31-72 (V.C.); +49-821-400-165505 (U.J.)
| | - Udo Jeschke
- Department of Obstetrics & Gynecology, University Hospital Augsburg, 86156 Augsburg, Germany
- Correspondence: (V.C.); (U.J.); Tel.: +33-4-11-28-31-72 (V.C.); +49-821-400-165505 (U.J.)
| |
Collapse
|
9
|
Batz F, Lermer E, Hatzler L, Vilsmaier T, Schröder L, Chelariu-Raicu A, Behr J, Mahner S, Buspavanich P, Thaler CJ. The Impact of the COVID-19 Pandemic on Sexual Health in Cis Women Living in Germany. J Sex Med 2022; 19:907-922. [PMID: 35370105 PMCID: PMC8898699 DOI: 10.1016/j.jsxm.2022.02.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 02/12/2022] [Accepted: 02/26/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Preliminary research shows a substantial impact of the COVID-19 pandemic on women's sexual health, whereby empirical work on sexual well-being of minoritized sexual identities is still rare. AIM The objective of this study was to explore sexual health in heterosexual, lesbian and bisexual cis women during the first wave of COVID-19 pandemic in Germany. METHODS An anonymous nationwide online survey was conducted among cis women during the first nationwide lockdown in Germany from April 20th to July 20th, 2020. The questionnaire was distributed via e-mail, online chats and social-media platforms. OUTCOMES Demographic variables and self-report measures from the Sexual Behavior Questionnaire (SBQ-G) "before the pandemic" and "since the pandemic" were collected. RESULTS A total of 1,368 cis women participants were included: heterosexual women (n = 844), lesbian women (n = 293), bisexual women (n = 231). Results indicate overall decrease in frequency of sexual contacts and masturbation during the COVID-19 pandemic. Regarding differences before and during the pandemic lesbian women showed significant changes in sexual arousal whereas heterosexual women showed significant changes in all dimensions except capability to enjoy sexual intercourse. The data of bisexual women showed significant changes in almost all dimensions except for frequency of sexual intercourse and sexual arousal. Results of the multiple regression analysis revealed that being younger than 36 years-old, and being in a relationship as well as being heterosexual (compared with being lesbian) is positively associated with general satisfaction with sexual life during the pandemic. CLINICAL IMPLICATIONS The findings suggest that during a pandemic sexual and mental health care for (cis) women should be provided and address the specific needs of sexual minority groups. STRENGTHS & LIMITATIONS This is the first study to describe sexual behavior in heterosexual, lesbian and bisexual women during the COVID-19 pandemic in Germany. Limitations, however, include the fact that the data described were obtained at only one time point so there is a possibility of recall bias, and that the results cannot be generalized because of the underrepresentation of women over age 46. CONCLUSION This study examined the impact of the COVID-19 pandemic and resulting social constraints on the sexual health of particular groups of lesbian and bisexual women, which may improve preparedness for future public health and policy crises. Batz F, Lermer E, Hatzler L, et al. The Impact of the COVID-19 Pandemic on Sexual Health in Cis Women Living in Germany. J Sex Med 2022;19:907-922.
Collapse
Affiliation(s)
- Falk Batz
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Germany
| | - Eva Lermer
- Center for Leadership and People Management, LMU Munich, Germany; Applied Business and Media Psychology - Ansbach University of Applied Sciences, Ansbach, Germany
| | - Laura Hatzler
- Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany; Department of Gynecology and Breast Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Germany
| | - Lennard Schröder
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Germany
| | - Anca Chelariu-Raicu
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Germany
| | - Joachim Behr
- Research Department of Experimental and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany; Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, Brandenburg University of Technology Cottbus-Senftenberg and Brandenburg Medical School, Potsdam, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Germany
| | - Pichit Buspavanich
- Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany; Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, Brandenburg University of Technology Cottbus-Senftenberg and Brandenburg Medical School, Potsdam, Germany; Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany; Institute Gender in Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
| | - Christian J Thaler
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Germany
| |
Collapse
|
10
|
Köpke BM, Garrido F, Vilsmaier T, Zati Zehni A, Kessler M, Mahner S, Chateau MC, Boissière-Michot F, Cavailles V, Dannecker C, Jeschke U, Ditsch N. Einfluss von Kernrezeptor-Expression und Einstrom von Tumor-infiltrierenden Lymphozyten auf das Überleben von Brustkrebspatientinnen. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1749032] [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: 10/18/2022] Open
Affiliation(s)
- B M Köpke
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Augsburg
| | - F Garrido
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Augsburg
| | - T Vilsmaier
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - A Zati Zehni
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - M Kessler
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - S Mahner
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - M-C Chateau
- Institut Régional du Cancer de Montpellier (ICM), Montpellier, France
| | | | | | - C Dannecker
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Augsburg
| | - U Jeschke
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Augsburg
| | - N Ditsch
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Augsburg
| |
Collapse
|
11
|
Löb S, Vilsmaier T, Schmoeckel E, Mahner S, Wöckel A, Jeschke U. Die Rolle von IL-1β und IL-18 beim rezidivierenden Frühabort. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1749061] [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: 10/18/2022] Open
Affiliation(s)
- S Löb
- Frauenklinik und Poliklinik, Universitätsklinikum, Würzburg
| | - T Vilsmaier
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - E Schmoeckel
- Pathologisches Institut, Universitätsklinikum der LMU, München
| | - S Mahner
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - A Wöckel
- Frauenklinik und Poliklinik, Universitätsklinikum, Würzburg
| | - U Jeschke
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Augsburg
| |
Collapse
|
12
|
Schneider M, Köpke MB, Vilsmaier T, Zati Zehni A, Kessler M, Shao W, Mahner S, Cavailles V, Dannecker C, Jeschke U, Ditsch N. Die nukleäre Expression des Thyroidhormon-Rezeptors alpha 2 (TRα2) ist ein unabhängiger positiver prognostischer Marker für Patientinnen mit Mammakarzinom. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1749036] [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: 10/18/2022] Open
Affiliation(s)
- M Schneider
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Augsburg
| | - MB Köpke
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Augsburg
| | - T Vilsmaier
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - A Zati Zehni
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - M Kessler
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - W Shao
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - S Mahner
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - V Cavailles
- IRCM-Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Montpellier
| | - C Dannecker
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Augsburg
| | - U Jeschke
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Augsburg
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum der LMU, München
| | - N Ditsch
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Augsburg
| |
Collapse
|
13
|
Keckstein S, Tilgener C, Jeschke U, Hofmann S, Vilsmaier T, Kaltofen T, Heidegger H, Batz F, Mahner S, Schröder L. Effects of matcha tea extract on cell viability and peroxisome proliferator-activated receptor γ expression on T47D breast cancer cells. Arch Gynecol Obstet 2022; 306:451-459. [PMID: 35079875 PMCID: PMC9349150 DOI: 10.1007/s00404-021-06381-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/23/2021] [Indexed: 01/16/2023]
Abstract
PURPOSE In the following work, we investigated the nuclear peroxisome proliferator-activated receptor gamma (PPARγ)-dependent proliferation behavior of breast cancer cells after stimulation with matcha green tea extract (MTE). METHODS T47D cells were stimulated with MTE at concentrations of 5, 10 and 50 µg/ml. Cell viability was assessed using a WST-1 assay after an incubation time of 72 h. PPARγ expression was quantified at the gene level by real-time polymerase chain reaction (PCR). A western blot (WB) was carried out for the qualitative assessment of the expression behavior of on a protein level. RESULTS The WST-1 test showed a significant inhibition of viability in T47D cells after 72 h at 5, 10 and 50 µg/ml. The PCR showed an overexpression of PPARγ in T47D cells in all concentrations. At the concentration of 50 µg/ml the expression was significantly increased (p < 0.05). The WB demonstrated a significant quantitative increase of PPARγ at protein level with MTE concentrations of 10 and 50 µg/ml. In addition, there was a negative correlation between the overexpression of PPAR γ and the inhibition of proliferation. CONCLUSION MTE decreases the cell viability of T47D cells and furthermore leads to an overexpression of PPARγ on protein and mRNA level.
Collapse
Affiliation(s)
- Simon Keckstein
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Constantin Tilgener
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
- Department of Urology and Transplant Surgery, Klinikum Stuttgart, Kriegsbergstraße. 60, 70174, Stuttgart, Germany
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
- Department of Obstetrics and Gynecology, University Hospital Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany.
| | - Simone Hofmann
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Till Kaltofen
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Helene Heidegger
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Falk Batz
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Lennard Schröder
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| |
Collapse
|
14
|
Tamalunas A, Lenau P, Stadelmeier LF, Mumm JN, Vilsmaier T, Höhn H, Mumm ML, Waidelich R, Casuscelli J, Magistro G, Buchner A, Kolben T, Stief C, Hennenberg M. Gender Bias in Urology: How Do Patients Really Choose Their Urologist? Patient Prefer Adherence 2022; 16:3001-3013. [PMID: 36353408 PMCID: PMC9639417 DOI: 10.2147/ppa.s384967] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
PURPOSE The present study aimed to investigate the influence of patients' and urologists' gender when choosing a urologist. With rising population diversity through immigration and generational differences, patient-centered healthcare has recently moved to the focus of European healthcare systems. As healthcare in urology often concentrates on sensitive topics, and often involves gender-specific diseases, research on the influence of gender on decision-making processes is of high importance. Understanding influence of gender on patients' choices in real life would provide patients, and physicians alike, with the means to provide better resources to achieve greater satisfaction from visits to a urologist. PATIENTS AND METHODS A questionnaire was prepared, and patients at our tertiary referral center were given the opportunity to voluntarily participate in our survey. We collected questionnaires from 1012 patients during their visits from June 2021 to October 2021. RESULTS Patients were divided into groups according to their gender: male (n=763), female (n=246), and non-binary (n=3). Our patient cohort consisted of more men than women (75% vs 24%), with only three patients identifying as non-binary. Irrespective of the patients' own gender, patients preferred a male urologist when problems were considered embarrassing, limiting daily activities, or when worrisome. When problems were considered painful, all patients preferred a female urologist. When patients had had a previous positive experience with a female or male urologist, they preferred to be treated by a female or male urologist, respectively. Overall, 65% of patients stated a gender preference for at least one given situation, or consultation scenario. CONCLUSION As the majority of our patients stated a gender preference, urological departments should be considerate of potential patients' preferences for urologist gender that may be based on the individual patient's history, taking a comprehensive approach to fulfill the patients' need for same gender urologists in educational hospitals and health care services.
Collapse
Affiliation(s)
- Alexander Tamalunas
- Department of Urology, University Hospital, LMU Munich, Munich, Germany
- Correspondence: Alexander Tamalunas, Department of Urology, University Hospital, LMU Munich, Marchioninistr. 15, Munich, 81377, Germany, Tel +49 89 4400 – 0, Email
| | - Philipp Lenau
- Department of Urology, University Hospital, LMU Munich, Munich, Germany
| | | | - Jan-Niclas Mumm
- Department of Urology, University Hospital, LMU Munich, Munich, Germany
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Henrik Höhn
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Maja-Lena Mumm
- Department of Political and Social Sciences, Institute for Media and Communication Studies, Freie Universität Berlin, Berlin, Germany
| | | | | | - Giuseppe Magistro
- Department of Urology, University Hospital, LMU Munich, Munich, Germany
| | - Alexander Buchner
- Department of Urology, University Hospital, LMU Munich, Munich, Germany
| | - Thomas Kolben
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Christian Stief
- Department of Urology, University Hospital, LMU Munich, Munich, Germany
| | - Martin Hennenberg
- Department of Urology, University Hospital, LMU Munich, Munich, Germany
| |
Collapse
|
15
|
Löb S, Ochmann B, Ma Z, Vilsmaier T, Kuhn C, Schmoeckel E, Herbert SL, Kolben T, Wöckel A, Mahner S, Jeschke U. The role of Interleukin-18 in recurrent early pregnancy loss. J Reprod Immunol 2021; 148:103432. [PMID: 34627076 DOI: 10.1016/j.jri.2021.103432] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 05/11/2021] [Revised: 09/11/2021] [Accepted: 10/01/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND A successful pregnancy is a unique and complex immunological state. Cytokines seem to be crucial for the implementation of a tolerogenic environment at the feto-maternal interphase towards the semi-allogenic fetus. Importantly, the switch from a Th1- to a Th2 cytokine profile might play a key role. Interestingly, Interleukin-18 (IL-18) can induce either Th1 or Th2 immune response depending on the local cytokine environment. Therefore, this study investigates the expression of IL-18 in early pregnancy loss. PATIENTS AND METHODS The TaqMan® Human Cytokine Network Array was carried out with placental tissue of patients with healthy pregnancies (n = 15) and recurrent miscarriage (n = 15) in order to investigate differences in IL-18 mRNA expression. Immunohistochemical staining was applied to examine the IL-18 protein expression in the syncytiotrophoblast and decidua of healthy pregnancies (n = 15), spontaneous (n = 12) and recurrent miscarriage (n = 9). The characterization of IL-18 expressing cells in the decidua was evaluated by double-immunofluorescence. Correlation analysis between IL-18 protein expression and clinical data of the study population was performed via spearman correlation coefficient. RESULTS Gene expression analysis revealed a 4,9-times higher expression of IL-18 in recurrent miscarriage patients. IL-18 protein expression was significantly upregulated only in the decidua in the recurrent miscarriage group (p = 0.031). We did not observe significant changes of IL-18 protein expression in spontaneous miscarriage specimens when compared to healthy controls (p = 0.172). Double-immunofluorescence identified decidual stroma cells as IL-18 expressing cells. Correlation analysis showed a significant negative correlation of IL-18 protein expression and gestational age in healthy controls (r = -,745, p = 0.034). Also, a positive correlation of IL-18 and maternal age was observed in patients suffering from recurrent pregnancy loss (r =, 894, p = 0.041). CONCLUSION Our results indicate that IL-18 expression might be necessary in early gestation but requires a tight regulation for a successful ongoing pregnancy. In the present study we observed that a significant upregulation of IL-18 in the decidua was restricted to patients with recurrent miscarriage and therefore might be interesting as a diagnostic marker. Further studies need to evaluate the exact pathophysiological mechanisms.
Collapse
Affiliation(s)
- Sanja Löb
- Department of Obstetrics and Gynecology, University Hospital, University of Wuerzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Beate Ochmann
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Zhi Ma
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Christina Kuhn
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany; Department of Obstetrics and Gynecology, University Hospital Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany
| | - Elisa Schmoeckel
- Department of Pathology, LMU Munich, Marchioninistr. 27, 81377, Munich, Germany
| | - Saskia-Laureen Herbert
- Department of Obstetrics and Gynecology, University Hospital, University of Wuerzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Thomas Kolben
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Achim Wöckel
- Department of Obstetrics and Gynecology, University Hospital, University of Wuerzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany; Department of Obstetrics and Gynecology, University Hospital Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany.
| |
Collapse
|
16
|
Mumm JN, Eismann L, Rodler S, Vilsmaier T, Zehni AZ, Apfelbeck M, Pfitzinger PL, Volz Y, Chaloupka M, Bauer RM, Stief CG, Staehler M. Listening to Music during Outpatient Cystoscopy Reduces Pain and Anxiety and Increases Satisfaction: Results from a Prospective Randomized Study. Urol Int 2021; 105:792-798. [PMID: 34280934 DOI: 10.1159/000517275] [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: 11/28/2020] [Accepted: 04/22/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND This study investigates the effect of classical music, music of patients' own choice, or no music on pain reduction during elective cystoscopy. OBJECTIVES The aim of the study was to describe the effect of listening to classical music, music of patients' own choice, or no music on patient's pain and satisfaction rates when carrying out an elective cystoscopy and the effect on the assessment capability of the performing urologist. DESIGN, SETTING, AND PARTICIPANTS This randomized trial included 127 patients undergoing elective cystoscopy at the Urological Department of the University Clinic of Munich between June 2019 and March 2020. Outcome Measurements and Statistical Analysis: Patients were assigned randomly to 3 groups: group I: listening to standardized classical music (n = 35), group II: listening to music according to the patients' choice (n = 34), and control group III: no music (n = 44). Prior to cystoscopy, anxiety levels were assessed by the Beck Anxiety Inventory (BAI). The Visual Analog Scale (VAS, range 1-100) was used for a self-assessment of pain, discomfort, and satisfaction. Statistical analysis was done with Spearman's rank correlation and t-tests. RESULTS AND LIMITATIONS The median age was 63 (range 27-91) years. The duration of cystoscopy was 5.7 (1-30) min. Patients had undergone a median of 2.3 cystoscopies in the past. Between giving informed consent and cystoscopy, patients had to wait for a median of 64 (0-260) min. The median VAS pain score was significantly lower in group I at 1.7 and group II at 2.3 versus 5.2 in the control group III (p < 0.001). The control group III had significantly worse pain and patient satisfaction rates compared with groups I and II. Group I had a significant lower VAS pain score than groups II and III (p < 0.001). Classical music also increased the assessment capability of the preforming urologist. CONCLUSIONS Listening to music during elective cystoscopy significantly reduces pain and distress and leads to higher patient and surgeon satisfaction. We recommend listening to classical music or music chosen by the patients during outpatient flexible/rigid cystoscopy in daily clinical routine. Patient Summary: In this study, we found that patients who listened to classical music or music of their own choice while undergoing a cystoscopy showed significant reduction of pain and distress.
Collapse
Affiliation(s)
- Jan-Niclas Mumm
- Department of Urology, Ludwig-Maximlians-University Munich (LMU), Munich, Germany
| | - Lennert Eismann
- Department of Urology, Ludwig-Maximlians-University Munich (LMU), Munich, Germany
| | - Severin Rodler
- Department of Urology, Ludwig-Maximlians-University Munich (LMU), Munich, Germany
| | - Theresa Vilsmaier
- Department of Gynacology, Ludwig-Maximlians-University Munich (LMU), Munich, Germany
| | - Alaleh Zati Zehni
- Department of Gynacology, Ludwig-Maximlians-University Munich (LMU), Munich, Germany
| | - Maria Apfelbeck
- Department of Urology, Ludwig-Maximlians-University Munich (LMU), Munich, Germany
| | - Paulo L Pfitzinger
- Department of Urology, Ludwig-Maximlians-University Munich (LMU), Munich, Germany
| | - Yannic Volz
- Department of Urology, Ludwig-Maximlians-University Munich (LMU), Munich, Germany
| | - Michael Chaloupka
- Department of Urology, Ludwig-Maximlians-University Munich (LMU), Munich, Germany
| | - Ricarda M Bauer
- Department of Urology, Ludwig-Maximlians-University Munich (LMU), Munich, Germany
| | - Christian G Stief
- Department of Urology, Ludwig-Maximlians-University Munich (LMU), Munich, Germany
| | - Michael Staehler
- Department of Urology, Ludwig-Maximlians-University Munich (LMU), Munich, Germany
| |
Collapse
|
17
|
Tamalunas A, Buchner A, Hennenberg M, Stadelmeier LF, Höhn H, Vilsmaier T, Mumm ML, Kolben T, Stief CG, Mumm JN. Choosing a Specialist: An Explanatory Study of Factors Influencing Patients in Choosing a Urologist. Urol Int 2021; 105:749-756. [PMID: 34274925 DOI: 10.1159/000517291] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/30/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVES While research on doctor-patient interaction has often focused on the decision-making abilities of physicians, it rarely centers around the question of how patients choose their respective practitioners. Research on fundamental decision processes is of high importance and understanding the factors that influence people's choices in real-life decision-making would potentially provide patients, and physicians alike, with the means to provide better resources to achieve greater satisfaction from visits to a medical practitioner. METHODS At our tertiary referral center, patients were given the opportunity to voluntarily participate in our survey. We collected questionnaires from 1,002 patients during their visit from November 2018 to February 2020. Statistical analysis was performed using SPSS V26.0 software (SPSS Statistics, Version 26.0.; IBM, Armonk, NY, USA). Results are reported as percentages for categorial variables. RESULTS Our patient cohort consisted of a higher percentage of men than of women (82 vs. 18%) with significantly more men having a university-based education (44 vs. 31%; p = 0.001). Women were more likely to have statutory health insurance than men (85 vs. 74%; p = 0.013). Men significantly preferred to be treated by a doctor of the same sex (24 vs. 8%; p < 0.001), which significantly increased with age. Overall, more women than men trusted a referral by their primary care physician (75 vs. 66%, p = 0.017), while preference of a higher academic degree in the attending urologist was significantly correlated with the patients' education. CONCLUSIONS Information on a specialist, such as professional qualifications and academic accomplishments, is easily accessible to patients with or without access to the Internet. However, recommendations and referrals, in addition to consistent care by the same treating physician, seem to be of high importance to all patients, regardless of gender or age.
Collapse
Affiliation(s)
| | - Alexander Buchner
- Department of Urology, University Hospital, LMU Munich, Munich, Germany
| | - Martin Hennenberg
- Department of Urology, University Hospital, LMU Munich, Munich, Germany
| | | | - Henrik Höhn
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Maja-Lena Mumm
- Department of Political and Social Sciences, Institute for Media and Communication Studies, Freie Universität, Berlin, Germany
| | - Thomas Kolben
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Christian G Stief
- Department of Urology, University Hospital, LMU Munich, Munich, Germany
| | - Jan-Niclas Mumm
- Department of Urology, University Hospital, LMU Munich, Munich, Germany
| |
Collapse
|
18
|
Mumm JN, Vilsmaier T, Schuetz JM, Rodler S, Zati Zehni A, Bauer RM, Staehler M, Stief CG, Batz F. How the COVID-19 Pandemic Affects Sexual Behavior of Hetero-, Homo-, and Bisexual Males in Germany. Sex Med 2021; 9:100380. [PMID: 34273787 PMCID: PMC8360921 DOI: 10.1016/j.esxm.2021.100380] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 02/03/2021] [Revised: 04/06/2021] [Accepted: 04/09/2021] [Indexed: 12/24/2022] Open
Abstract
Introduction The COVID-19 pandemic drastically altered the way of life around the world. Due to social distancing measures, contact restrictions and fears of infection, social life has changed significantly. These measures along with the stressors associated with the current worldwide situation, will inevitably have an effect on people's interpersonal and personal behaviors. Aim This study evaluates the effect the COVID-19 pandemic and nationwide German lockdown had on the sexual behavior of cis men. Methods An anonymous nationwide web-based questionnaire was conducted among cis men in Germany during the first COVID-19 home isolation (April 20, 2020–July 20, 2020). The questionnaire was distributed via e-mail, online chats and social-media platforms. Main Outcome Measures Data was collected on general characteristics including demographics and socio-economic backgrounds. To evaluate sexual health, questions from the Sexual Behavior Questionnaire were included. Results 523 cis male participated. 414 met the inclusion criteria. Most were heterosexual (n = 248, 59.9%; vs homosexual n = 97, 23.4%; vs bisexual n = 69, 16.7%). 243 (59%) were employed, 153 (37.1%) were students and 16 (3.9%) were unemployed. Most of the participants reported an annual income lower than 75.000€. During the lockdown, average weekly frequency of sexual intercourse and masturbation was increased in all groups. Consistently, a significant rise of higher satisfaction with the frequency of sexual contacts during the quarantine was observed (P < .05). Furthermore, the level of sexual arousal increased significantly in all groups (P < .0005). Capability to enjoy sexual intercourse or masturbation increased significantly in heterosexual (P < .0005) and homosexual men (P < .005). Bisexual participants showed a significant increase in general satisfaction with sexual life (P < .05) and a significant decrease in satisfaction in relationship or single life (P < .05). Positive confounders in the changing of sexual behavior during the COVID-19 pandemic were: Being in a relationship or being single, parenthood and being employed. Conclusion Our study firstly describes how COVID-19 pandemic related restrictions and social distancing measurements altered sexual behavior amongst cis male in Germany. Further studies, including sexual minorities specifically, are needed to clarify if the behavior in the first German nationwide quarantine has persisted or transformed as the pandemic proceeded. Mumm J-N, Vilsmaier T, Schuetz JM, et al. How the COVID-19 Pandemic Affects Sexual Behavior of Hetero-, Homo-, and Bisexual Males in Germany. Sex Med 2021;9:100380.
Collapse
Affiliation(s)
- Jan-Niclas Mumm
- Department of Urology, University Hospital, LMU Munich, Munich, Germany.
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Julius M Schuetz
- Department of Urology, University Hospital, LMU Munich, Munich, Germany
| | - Severin Rodler
- Department of Urology, University Hospital, LMU Munich, Munich, Germany
| | - Alaleh Zati Zehni
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - Ricarda M Bauer
- Department of Urology, University Hospital, LMU Munich, Munich, Germany
| | - Michael Staehler
- Department of Urology, University Hospital, LMU Munich, Munich, Germany
| | - Christian G Stief
- Department of Urology, University Hospital, LMU Munich, Munich, Germany
| | - Falk Batz
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| |
Collapse
|
19
|
Buspavanich P, Lech S, Lermer E, Fischer M, Berger M, Vilsmaier T, Kaltofen T, Keckstein S, Mahner S, Behr J, Thaler CJ, Batz F. Well-being during COVID-19 pandemic: A comparison of individuals with minoritized sexual and gender identities and cis-heterosexual individuals. PLoS One 2021; 16:e0252356. [PMID: 34101746 PMCID: PMC8186787 DOI: 10.1371/journal.pone.0252356] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/12/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Preliminary empirical data indicates a substantial impact of the COVID-19 pandemic on well-being and mental health. Individuals with minoritized sexual and gender identities are at a higher risk of experiencing such negative changes in their well-being. The objective of this study was to compare levels of well-being among cis-heterosexual individuals and individuals with minoritized sexual and gender identities during the COVID-19 pandemic. METHODS Using data obtained in a cross-sectional online survey between April 20 to July 20, 2020 (N = 2332), we compared levels of well-being (WHO-5) across subgroups (cis-individuals with minoritized sexual identities, individuals with minoritized gender identities and cis-heterosexual individuals) applying univariate (two-sample t-test) and multivariate analysis (multivariate linear regression). RESULTS Results indicate overall lower levels of well-being as well as lower levels of well-being in minoritized sexual or gender identities compared to cis-heterosexual individuals. Further, multivariate analyses revealed that living in urban communities as well as being in a relationship were positively associated with higher levels of well-being. Furthermore, a moderation analysis showed that being in a relationship reduces the difference between groups in terms of well-being. CONCLUSION Access to mental healthcare for individuals with minoritized sexual and gender identities as well as access to gender-affirming resources should be strengthened during COVID-19 pandemic. Healthcare services with low barriers of access such as telehealth and online peer support groups should be made available, especially for vulnerable groups.
Collapse
Affiliation(s)
- Pichit Buspavanich
- Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
- Department of Psychiatry and Psychotherapy, Charité –Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Institute of Sexology and Sexual Medicine, Charité –Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sonia Lech
- Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
- Department of Psychiatry and Psychotherapy, Charité –Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Institute of Medical Sociology and Rehabilitation Science, Charité –Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Eva Lermer
- Center for Leadership and People Management, LMU Munich, Munich, Germany
- FOM University of Applied Sciences of Economics and Management, Essen, Germany
| | - Mirjam Fischer
- Institute of Sociology and Social Psychology, University of Cologne, Cologne, Germany
| | - Maximilian Berger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
- Department of Psychiatry and Psychotherapy, Charité –Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Till Kaltofen
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Simon Keckstein
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Joachim Behr
- Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
- Research Department of Experimental and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Charité –Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, Brandenburg University of Technology Cottbus-Senftenberg and Brandenburg Medical School, Potsdam, Germany
| | - Christian J. Thaler
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Falk Batz
- Department of Obstetrics and Gynecology and Center for Gynecological Endocrinology and Reproductive Medicine, University Hospital, LMU Munich, Munich, Germany
| |
Collapse
|
20
|
Mumm JN, Abrarova B, Schütz J, Klehr B, Rodler S, Vilsmaier T, Gozzi C, Rehder P, May F, Homberg R, Gebhartl P, Stief CG, Buchner A, Bauer RM. Age at surgery is not a prognostic factor for the AdVance-XP male sling efficacy: A post-hoc analysis of a prospective 7-year multicentric study. Neurourol Urodyn 2021; 40:1616-1624. [PMID: 34082470 DOI: 10.1002/nau.24727] [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: 03/18/2021] [Revised: 05/11/2021] [Accepted: 05/15/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To evaluate the factor age at the surgery on long-term postoperative outcomes in patients with postprostatectomy incontinence (PPI) after AdVance XP transobturator male sling implantation. METHODS A total of 115 male patients with PPI, who had undergone AdVance XP sling implantation, were included. Patients had PPI with endoscopically confirmed good sphincteric-contractility and a positive coaptive response. Kruskal-Wallis test with Dunn post-hoc tests were used to analyze the postoperative outcome differences between the patient groups aged less than 66, 66-75, and over greater than 75 years. Outcome measures were the 24 h pad test, the number of daily pads used, the International Consultation on Incontinence Questionnaire short form (ICIQ-SF), International Quality of Life Score (IQOL), Patient Global Impression of Improvement (PGI-I), International Index of Erectile Function-5 (IIEF-5), International Prostate Symptom Score (IPSS), and Visual Analog Scale scores. Observation time points were 3, 6, 12, 24, 36, 48, 60, and 84 months after surgery. RESULTS Between the age groups, there was no difference in the success rate of the procedure (defined as 0 pads/24 h and less than 5 g in the 24-h pad test) at any point in time. Subjective parameters measures using the ICIQ-SF, PGI-I, IQOL, and IPSS scores showed no differences between the two cohorts. Only erectile function (IIEF-5 score) was lower in older patients in comparison to the cohort aged less than 66 years (p < 0.05 at 3, 6, 12, 24, 36, and 48 months). CONCLUSIONS The present study complements the European multicentre AdVance XP follow-up study. Here, we show that age at surgery does not affect the objective success, subjective success, or the complication rate. Thus, we do not recommend factoring in chronological age into surgical selection criteria for the AdVance XP implantation.
Collapse
Affiliation(s)
| | | | | | | | | | - Theresa Vilsmaier
- Department of Gynecology, University of Munich (LMU), Munich, Germany
| | | | - Peter Rehder
- Department of Urology, University Hospital Innsbruck, Innsbruck, Austria
| | - Florian May
- Department of Urology, Klinikum Dachau, Dachau, Germany
| | - Roland Homberg
- Department of Urology and Paediatric Urology, St. Barbara Hospital Hamm GmbH, Hamm, Germany
| | - Peter Gebhartl
- Department of Urology, Salzkammergut Klinikum Vocklabruck, Vocklabruck, Austria
| | | | | | | |
Collapse
|
21
|
Vilsmaier T, Amann N, Löb S, Schmoeckel E, Kuhn C, Zati Zehni A, Meister S, Beyer S, Kolben TM, Becker J, Mumm JN, Mahner S, Jeschke U, Kolben T. The decidual expression of Interleukin-7 is upregulated in early pregnancy loss. Am J Reprod Immunol 2021; 86:e13437. [PMID: 33934432 DOI: 10.1111/aji.13437] [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: 01/12/2021] [Revised: 04/01/2021] [Accepted: 04/12/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Maternal immunological rejection of the semi-allogenic fetus is discussed as one of the significant factors involved in early pregnancy loss. An array of cytokines secreted by both maternal and fetal cells is involved in generating a delicate maternal immune tolerance. Interleukin-7 (IL-7) is discussed to play a key role in pro-inflammatory processes, but there is still limited insight into the pathophysiological input on placentation and embryonic development in early pregnancy loss. PATIENTS AND METHODS Cytokine level differences were identified with quantitative real-time PCR in placental tissue from spontaneous abortions (SA) (n = 18), recurrent spontaneous abortions (RSA) (n = 15), and healthy pregnancies (n = 15) at gestational weeks 7 to 14. Protein expression of IL-7 in the decidua was investigated by immunohistochemistry. IL-7-expressing cells were identified with double-immunofluorescence. RESULTS Decidua of women with RSA expressed almost 51-times higher values of IL-7 in gene expression analysis. Immunohistochemistry identified a significant upregulation of IL-7 in the decidua of RSA specimens (p = .013) and in the decidua of women with SA (p = .004). Double-immunofluorescence confirmed decidual stroma cells as IL-7-expressing cells. CONCLUSION Significantly elevated IL-7 values in the decidua of spontaneous and recurrent miscarriages imply a crucial role of the cytokine in the signaling at the feto-maternal interface of the placenta. An overexpression of IL-7 could result in early pregnancy loss by inducing a pro-inflammatory environment. Proven to be valuable in other autoimmune diseases, targeting IL-7 signaling therapeutically may prove to be a very beneficial treatment option for RSA patients.
Collapse
Affiliation(s)
- Theresa Vilsmaier
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU Munich, Germany
| | - Niklas Amann
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU Munich, Germany
| | - Sanja Löb
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU Munich, Germany.,Department of Obstetrics and Gynecology, University Hospital, University of Wuerzburg, LMU Munich, Germany
| | - Elisa Schmoeckel
- Department of Pathology, University Hospital, LMU Munich, Germany
| | - Christina Kuhn
- Department of Obstetrics and Gynecology, University Hospital Augsburg, LMU Munich, Germany
| | - Alaleh Zati Zehni
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU Munich, Germany
| | - Sarah Meister
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU Munich, Germany
| | - Susanne Beyer
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU Munich, Germany
| | - Theresa M Kolben
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU Munich, Germany
| | - Johanna Becker
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU Munich, Germany
| | - Jan-Niclas Mumm
- Department of Urology, University Hospital, LMU Munich, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU Munich, Germany
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU Munich, Germany.,Department of Obstetrics and Gynecology, University Hospital Augsburg, LMU Munich, Germany
| | - Thomas Kolben
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU Munich, Germany
| |
Collapse
|
22
|
Beilner D, Kuhn C, Kost BP, Vilsmaier T, Vattai A, Kaltofen T, Mahner S, Schmoeckel E, Dannecker C, Jückstock J, Mayr D, Jeschke U, Heidegger HH. Nuclear receptor corepressor (NCoR) is a positive prognosticator for cervical cancer. Arch Gynecol Obstet 2021; 304:1307-1314. [PMID: 33861372 PMCID: PMC8490237 DOI: 10.1007/s00404-021-06053-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/17/2020] [Accepted: 03/27/2021] [Indexed: 12/19/2022]
Abstract
Purpose Enzymes with epigenetic functions play an essential part in development of cancer. However, the significance of epigenetic changes in cervical carcinoma as a prognostic factor has not been fully investigated. Nuclear receptor corepressor (NCoR) presents itself as a potentially important element for epigenetic modification and as a potential prognostic aspect in cervical cancer. Methods By immunohistochemical staining of 250 tumor samples, the expression strength of NCoR was measured and evaluated by immunoreactive score (IRS) in the nucleus and cytoplasm. Results A low expression of NCoR in our patients was a disadvantage in overall survival. Expression of NCoR was negatively correlated with viral oncoprotein E6, acetylated histone H3 acetyl K9 and FIGO status, and positively correlated to p53. Conclusions Our study has identified epigenetic modification of tumor cells thus seems to be of relevance in cervical cancer as well for diagnosis, as a marker or as a potential therapeutic target in patients with advanced cervical carcinoma.
Collapse
Affiliation(s)
- Daniel Beilner
- Department of Obstetrics and Gynaecology, Ludwig-Maximilians-University of Munich, Maistrasse 11, 80337, Munich, Germany
| | - Christina Kuhn
- Department of Obstetrics and Gynaecology, Ludwig-Maximilians-University of Munich, Maistrasse 11, 80337, Munich, Germany
| | - Bernd P Kost
- Department of Obstetrics and Gynaecology, Ludwig-Maximilians-University of Munich, Maistrasse 11, 80337, Munich, Germany
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynaecology, Ludwig-Maximilians-University of Munich, Maistrasse 11, 80337, Munich, Germany
| | - Aurelia Vattai
- Department of Obstetrics and Gynaecology, Ludwig-Maximilians-University of Munich, Maistrasse 11, 80337, Munich, Germany
| | - Till Kaltofen
- Department of Obstetrics and Gynaecology, Ludwig-Maximilians-University of Munich, Maistrasse 11, 80337, Munich, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynaecology, Ludwig-Maximilians-University of Munich, Maistrasse 11, 80337, Munich, Germany
| | - Elisa Schmoeckel
- Department of Pathology, LMU Munich, Thalkirchner Street 56, 80337, Munich, Germany
| | - Christian Dannecker
- Department of Obstetrics and Gynaecology, University Hospital Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany
| | - Julia Jückstock
- Department of Obstetrics and Gynaecology, Ludwig-Maximilians-University of Munich, Maistrasse 11, 80337, Munich, Germany
| | - Doris Mayr
- Department of Pathology, LMU Munich, Thalkirchner Street 56, 80337, Munich, Germany
| | - Udo Jeschke
- Department of Obstetrics and Gynaecology, Ludwig-Maximilians-University of Munich, Maistrasse 11, 80337, Munich, Germany. .,Department of Obstetrics and Gynaecology, University Hospital Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany.
| | - Helene Hildegard Heidegger
- Department of Obstetrics and Gynaecology, Ludwig-Maximilians-University of Munich, Maistrasse 11, 80337, Munich, Germany
| |
Collapse
|
23
|
Mumm JN, Klehr B, Rodler S, Kretschmer A, Vilsmaier T, Westhofen T, Chaloupka M, Schulz GB, Gozzi C, Rehder P, May F, Homberg R, Stief CG, Grabbert M, Bauer RM. Five-Year Results of a Prospective Multicenter Trial: AdVance XP for Postprostatectomy-Incontinence in Patients with Favorable Prognostic Factors. Urol Int 2021; 105:421-427. [PMID: 33517334 DOI: 10.1159/000512881] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 07/25/2020] [Accepted: 11/04/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of this study was to assess the security, value, and efficacy of the second-generation AdVance male sling XP (Boston Scientific®), after implementation in 2010 with advantageous modifications in the sling structure and needle shape, in a prospective multicenter long-term follow-up study. METHODS In total, 115 patients were included. Exclusion criteria were earlier incontinence (UI) surgery, nocturnal UI, former radiotherapy, or night-time incontinence. We also excluded patients with a functional urethra <1 cm in a preoperatively performed repositioning test. A consistent 24-h pad test, International Quality of Life (IQOL) score, visual analog pain scale (VAS), International Consultation-Incontinence Questionnaire (ICIQ-UI SF), International Index of Erectile Function (IIEF-5), International Prostate Symptom Score (IPSS), and Patient Global Impression of Improvement (PGI-I) scores were requested postoperatively. RESULTS The 24-month follow-up (114 patients) revealed 64.0% cured and 28.8% improved patients. Mean urine loss was reduced significantly to 19.0 g (p < 0.001). A mean PGI score of 1.5 and a mean VAS score of 0.2 were obtained. The 60-month follow-up (59 patients) revealed 57.6% cured and 25.4% improved patients. Mean urine loss was reduced significantly to 18.3 g (p < 0.001). A mean PGI score of 1.6 and a mean VAS score of 0.2 were obtained. CONCLUSIONS The AdVance XP displays excellent continence results and secure effectiveness over a 5-year period. Moreover, these data are demonstrating low complication rates and improved quality of life in the long-term use of AdVance XP.
Collapse
Affiliation(s)
- Jan-Niclas Mumm
- Department of Urology, University of Munich (LMU), Munich, Germany,
| | - Benedikt Klehr
- Department of Urology, University of Munich (LMU), Munich, Germany
| | - Severin Rodler
- Department of Urology, University of Munich (LMU), Munich, Germany
| | | | - Theresa Vilsmaier
- Department of Gynecology, University of Munich (LMU), Munich, Germany
| | - Thilo Westhofen
- Department of Urology, University of Munich (LMU), Munich, Germany
| | | | | | | | - Peter Rehder
- Department of Urology, University Hospital Innsbruck, Innsbruck, Austria
| | - Florian May
- Department of Urology, Klinikum Dachau, Dachau, Germany
| | - Roland Homberg
- Department of Urology and Paediatric Urology, St. Barbara Hospital Hamm GmbH, Hamm, Germany
| | | | - Markus Grabbert
- Department of Urology, University Hospital Freiburg, Freiburg, Germany
| | - Ricarda M Bauer
- Department of Urology, University of Munich (LMU), Munich, Germany
| |
Collapse
|
24
|
Zehni AZ, Batz F, Vattai A, Kaltofen T, Schrader S, Jacob SN, Mumm JN, Heidegger HH, Ditsch N, Mahner S, Jeschke U, Vilsmaier T. The Prognostic Impact of Retinoid X Receptor and Thyroid Hormone Receptor alpha in Unifocal vs. Multifocal/Multicentric Breast Cancer. Int J Mol Sci 2021; 22:957. [PMID: 33478016 PMCID: PMC7835829 DOI: 10.3390/ijms22020957] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 01/04/2021] [Revised: 01/11/2021] [Accepted: 01/18/2021] [Indexed: 12/24/2022] Open
Abstract
The aim of this study was to assess the prognostic value of the steroid hormone receptor expression, counting the retinoid X receptor (RXR) and thyroid hormone receptors (THRs), on the two different breast cancer (BC) entities: multifocal/multicentric versus unifocal. The overall and disease-free survival were considered as the prognosis determining aspects and analyzed by uni- and multi-variate analysis. Furthermore, histopathological grading and TNM staging (T = tumor size, N = lymph node involvement, M = distant metastasis) were examined in relation to RXR and THRs expression. A retrospective statistical analysis was carried out on survival-related events in a series of 319 sporadic BC patients treated at the Department of Gynecology and Obstetrics at the Ludwig-Maximillian's University in Munich between 2000 and 2002. The expression of RXR and THRs, including its two major isoforms THRα1 and THRα2, was analyzed by immunohistochemistry and showed to have a significant correlation for both BC entities in regard to survival analysis. Patients with multifocal/multicentric BC were exposed to a significantly worse disease-free survival (DFS) when expressing RXR. Patients with unifocal BC showed a significantly worse DFS when expressing THRα1. In contrast, a statistically significant positive association between THRα2 expression and enhanced DFS in multifocal/multicentric BC was shown. Especially the RXR expression in multifocal/multicentric BC was found to play a remarkably contradictory role for BC prognosis. The findings imply the need for a critical review of possible molecular therapies targeting steroid hormone receptors in BC treatment. Our results strengthen the need to further investigate the behavior of the nuclear receptor family, especially in relation to BC focality.
Collapse
Affiliation(s)
- Alaleh Zati Zehni
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU, 80337 Munich, Germany; (A.Z.Z.); (F.B.); (A.V.); (T.K.); (S.S.); (H.H.H.); (N.D.); (S.M.); (T.V.)
| | - Falk Batz
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU, 80337 Munich, Germany; (A.Z.Z.); (F.B.); (A.V.); (T.K.); (S.S.); (H.H.H.); (N.D.); (S.M.); (T.V.)
| | - Aurelia Vattai
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU, 80337 Munich, Germany; (A.Z.Z.); (F.B.); (A.V.); (T.K.); (S.S.); (H.H.H.); (N.D.); (S.M.); (T.V.)
| | - Till Kaltofen
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU, 80337 Munich, Germany; (A.Z.Z.); (F.B.); (A.V.); (T.K.); (S.S.); (H.H.H.); (N.D.); (S.M.); (T.V.)
| | - Svenja Schrader
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU, 80337 Munich, Germany; (A.Z.Z.); (F.B.); (A.V.); (T.K.); (S.S.); (H.H.H.); (N.D.); (S.M.); (T.V.)
| | - Sven-Niclas Jacob
- Department of General, Visceral, Transplant, Vascular and Thoracic Surgery, LMU, Marchioninistraße 15, 81377 Munich, Germany;
| | - Jan-Niclas Mumm
- Department of Urology, LMU, Marchioninistraße 15, 81377 Munich, Germany;
| | - Helene Hildegard Heidegger
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU, 80337 Munich, Germany; (A.Z.Z.); (F.B.); (A.V.); (T.K.); (S.S.); (H.H.H.); (N.D.); (S.M.); (T.V.)
| | - Nina Ditsch
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU, 80337 Munich, Germany; (A.Z.Z.); (F.B.); (A.V.); (T.K.); (S.S.); (H.H.H.); (N.D.); (S.M.); (T.V.)
- Department of Obstetrics and Gynecology, University Hospital, 86156 Augsburg, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU, 80337 Munich, Germany; (A.Z.Z.); (F.B.); (A.V.); (T.K.); (S.S.); (H.H.H.); (N.D.); (S.M.); (T.V.)
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU, 80337 Munich, Germany; (A.Z.Z.); (F.B.); (A.V.); (T.K.); (S.S.); (H.H.H.); (N.D.); (S.M.); (T.V.)
- Department of Obstetrics and Gynecology, University Hospital, 86156 Augsburg, Germany
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynecology, University Hospital Munich, LMU, 80337 Munich, Germany; (A.Z.Z.); (F.B.); (A.V.); (T.K.); (S.S.); (H.H.H.); (N.D.); (S.M.); (T.V.)
| |
Collapse
|
25
|
Löb S, Vattai A, Kuhn C, Schmoeckel E, Mahner S, Wöckel A, Kolben T, Keil C, Jeschke U, Vilsmaier T. Pregnancy Zone Protein (PZP) is significantly upregulated in the decidua of recurrent and spontaneous miscarriage and negatively correlated to Glycodelin A (GdA). J Reprod Immunol 2020; 143:103267. [PMID: 33388716 DOI: 10.1016/j.jri.2020.103267] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/10/2020] [Accepted: 12/16/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Pregnancy Zone Protein (PZP) is an immunosuppressive protein that is expressed by the placenta and has also been identified in immune cells. When PZP and Glycodelin A (GdA) are combined, they act synergistically to inhibit Th-1 immune response. Little is known about its combined expression and role in normal and disturbed first trimester pregnancy. PATIENTS AND METHODS We investigated the expression of PZP and GdA in placental tissue obtained from spontaneous miscarriage (SM) (n = 19) and recurrent miscarriage (RM) (n = 17) at gestational weeks 6-13 by immunohistochemistry and on mRNA-level by either TaqMan PCR or in situ hybridization. Placental tissue from legal terminations of healthy pregnancies (n = 15) served as control group. Immunofluorescence double staining was used to analyse the combined expression of PZP and GdA in decidual tissue. RESULTS The protein level of PZP was significantly increased in decidual stroma of SM samples compared to the decidua of control specimens and also significantly upregulated in the decidual stroma cells in the RM group. Concerning GdA, the decidual stroma revealed a significantly decreased protein level in the group with spontaneous abortions than in the group with healthy pregnancies. There was also a significant downregulation of GdA in the decidual stroma of RM samples compared to the control group. We observed a significant negative correlation of PZP and GdA in decidual stromal tissue of recurrent abortion. We could confirm the staining results for PZP as well as for GdA on mRNA level. Both proteins are co-localized in decidual stroma as analysed by immunofluorescence double staining. CONCLUSION A balanced expression of GdA and its carrier protein PZP in the decidua seems crucial for a successful ongoing pregnancy. According to our data, these immunosuppressive proteins are co-localized in the decidual tissue and show a negative correlation only in patients suffering from recurrent abortion.
Collapse
Affiliation(s)
- Sanja Löb
- Department of Obstetrics and Gynecology, University Hospital, University of Wuerzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany; Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337, Munich, Germany
| | - Aurelia Vattai
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337, Munich, Germany
| | - Christina Kuhn
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337, Munich, Germany; Department of Obstetrics and Gynecology, University Hospital Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany
| | - Elisa Schmoeckel
- Department of Pathology, LMU Munich, Marchioninistr. 27, 81377, Munich, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337, Munich, Germany
| | - Achim Wöckel
- Department of Obstetrics and Gynecology, University Hospital, University of Wuerzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Thomas Kolben
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337, Munich, Germany
| | - Christiane Keil
- Department of Orthodontics, Universitätsklinikum Carl Gustav Carus, Fetscherstraße 74, 01307, Dresden, Germany
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337, Munich, Germany; Department of Obstetrics and Gynecology, University Hospital Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany.
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337, Munich, Germany
| |
Collapse
|
26
|
Zheng M, Mullikin H, Hester A, Czogalla B, Heidegger H, Vilsmaier T, Vattai A, Chelariu-Raicu A, Jeschke U, Trillsch F, Mahner S, Kaltofen T. Development and Validation of a Novel 11-Gene Prognostic Model for Serous Ovarian Carcinomas Based on Lipid Metabolism Expression Profile. Int J Mol Sci 2020; 21:E9169. [PMID: 33271935 PMCID: PMC7731240 DOI: 10.3390/ijms21239169] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 11/06/2020] [Accepted: 11/27/2020] [Indexed: 02/06/2023] Open
Abstract
(1) Background: Biomarkers might play a significant role in predicting the clinical outcomes of patients with ovarian cancer. By analyzing lipid metabolism genes, future perspectives may be uncovered; (2) Methods: RNA-seq data for serous ovarian cancer were downloaded from The Cancer Genome Atlas and Gene Expression Omnibus databases. The non-negative matrix factorization package in programming language R was used to classify molecular subtypes of lipid metabolism genes and the limma package in R was performed for functional enrichment analysis. Through lasso regression, we constructed a multi-gene prognosis model; (3) Results: Two molecular subtypes were obtained and an 11-gene signature was constructed (PI3, RGS, ADORA3, CH25H, CCDC80, PTGER3, MATK, KLRB1, CCL19, CXCL9 and CXCL10). Our prognostic model shows a good independent prognostic ability in ovarian cancer. In a nomogram, the predictive efficiency was notably superior to that of traditional clinical features. Related to known models in ovarian cancer with a comparable amount of genes, ours has the highest concordance index; (4) Conclusions: We propose an 11-gene signature prognosis prediction model based on lipid metabolism genes in serous ovarian cancer.
Collapse
Affiliation(s)
- Mingjun Zheng
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337 Munich, Germany; (M.Z.); (H.M.); (A.H.); (B.C.); (H.H.); (T.V.); (A.V.); (A.C.-R.); (U.J.); (F.T.); (S.M.)
| | - Heather Mullikin
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337 Munich, Germany; (M.Z.); (H.M.); (A.H.); (B.C.); (H.H.); (T.V.); (A.V.); (A.C.-R.); (U.J.); (F.T.); (S.M.)
| | - Anna Hester
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337 Munich, Germany; (M.Z.); (H.M.); (A.H.); (B.C.); (H.H.); (T.V.); (A.V.); (A.C.-R.); (U.J.); (F.T.); (S.M.)
| | - Bastian Czogalla
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337 Munich, Germany; (M.Z.); (H.M.); (A.H.); (B.C.); (H.H.); (T.V.); (A.V.); (A.C.-R.); (U.J.); (F.T.); (S.M.)
| | - Helene Heidegger
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337 Munich, Germany; (M.Z.); (H.M.); (A.H.); (B.C.); (H.H.); (T.V.); (A.V.); (A.C.-R.); (U.J.); (F.T.); (S.M.)
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337 Munich, Germany; (M.Z.); (H.M.); (A.H.); (B.C.); (H.H.); (T.V.); (A.V.); (A.C.-R.); (U.J.); (F.T.); (S.M.)
| | - Aurelia Vattai
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337 Munich, Germany; (M.Z.); (H.M.); (A.H.); (B.C.); (H.H.); (T.V.); (A.V.); (A.C.-R.); (U.J.); (F.T.); (S.M.)
| | - Anca Chelariu-Raicu
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337 Munich, Germany; (M.Z.); (H.M.); (A.H.); (B.C.); (H.H.); (T.V.); (A.V.); (A.C.-R.); (U.J.); (F.T.); (S.M.)
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337 Munich, Germany; (M.Z.); (H.M.); (A.H.); (B.C.); (H.H.); (T.V.); (A.V.); (A.C.-R.); (U.J.); (F.T.); (S.M.)
- Department of Obstetrics and Gynecology, University Hospital Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany
| | - Fabian Trillsch
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337 Munich, Germany; (M.Z.); (H.M.); (A.H.); (B.C.); (H.H.); (T.V.); (A.V.); (A.C.-R.); (U.J.); (F.T.); (S.M.)
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337 Munich, Germany; (M.Z.); (H.M.); (A.H.); (B.C.); (H.H.); (T.V.); (A.V.); (A.C.-R.); (U.J.); (F.T.); (S.M.)
| | - Till Kaltofen
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337 Munich, Germany; (M.Z.); (H.M.); (A.H.); (B.C.); (H.H.); (T.V.); (A.V.); (A.C.-R.); (U.J.); (F.T.); (S.M.)
| |
Collapse
|
27
|
Simon C, Büchel J, Delius M, Alba-Alejandre I, Eisenmann P, Schönfeld M, Vilsmaier T, Mahner S, Jückstock J. Maternales Mirror-Syndrom bei fetalem Hydrops fetalis nach konnataler CMV-Infektion. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718318] [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)
- C Simon
- Ludwig-Maximilians-Universität München, Frauenklinik Innenstadt
| | - J Büchel
- Ludwig-Maximilians-Universität München, Frauenklinik Innenstadt
| | - M Delius
- Ludwig-Maximilians-Universität München, Frauenklinik Innenstadt
| | | | - P Eisenmann
- Ludwig-Maximilians-Universität München, Frauenklinik Innenstadt
| | - M Schönfeld
- Ludwig-Maximilians-Universität München, Frauenklinik Innenstadt
| | - T Vilsmaier
- Ludwig-Maximilians-Universität München, Frauenklinik Innenstadt
| | - S Mahner
- Ludwig-Maximilians-Universität München, Frauenklinik Innenstadt
| | - J Jückstock
- Ludwig-Maximilians-Universität München, Frauenklinik Innenstadt
| |
Collapse
|
28
|
Becker J, Vilsmaier T, Franz M, Rogenhofer N, CJ T. Stimulationsdauer und Oozytenzahl bei konsekutiver ovarieller Stimulation nach verkürztem Intervall (duale Stimulation; DUO-S). Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717669] [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)
- J Becker
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der LMU München, Hormon-und Kinderwunschzentrum
| | - T Vilsmaier
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der LMU München, Hormon-und Kinderwunschzentrum
| | - M Franz
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der LMU München, Hormon-und Kinderwunschzentrum
| | - N Rogenhofer
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der LMU München, Hormon-und Kinderwunschzentrum
| | - Thaler CJ
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der LMU München, Hormon-und Kinderwunschzentrum
| |
Collapse
|
29
|
Becker J, Vilsmaier T, Rogenhofer N, Thaler C. Vitrifikation von Metaphase II Oozyten aus medizinischer und nicht-medizinischer Indikation: Fertilitätsprotektion versus Social Freezing. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718233] [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)
- J Becker
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der LMU München, Hormon-und Kinderwunschzentrum
| | - T Vilsmaier
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der LMU München, Hormon-und Kinderwunschzentrum
| | - N Rogenhofer
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der LMU München, Hormon-und Kinderwunschzentrum
| | - C Thaler
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der LMU München, Hormon-und Kinderwunschzentrum
| |
Collapse
|
30
|
Zati Zehni A, Jeschke U, Hester A, Kolben T, Ditsch N, Jacob SN, Mumm JN, Heidegger HH, Mahner S, Vilsmaier T. EP3 Is an Independent Prognostic Marker Only for Unifocal Breast Cancer Cases. Int J Mol Sci 2020; 21:ijms21124418. [PMID: 32580276 PMCID: PMC7352354 DOI: 10.3390/ijms21124418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/16/2020] [Accepted: 06/18/2020] [Indexed: 02/07/2023] Open
Abstract
The aim of this study was to evaluate the prognostic impact of prostaglandin E2 receptor 3 (EP3) receptor expression might have on the two different breast cancer entities: multifocal/multicentric versus unifocal. As the prognosis determining aspects, we investigated the overall- and disease-free survival by uni-and multivariate analysis. To underline the study’s conclusion, we additionally considered the histopathological grading and the tumor node metastasis (TNM) staging system. A retrospective statistical analysis was performed on survival related events in a series of 289 sporadic breast cancer (BC) patients treated at the Department of Obstetrics and Gynecology at the Ludwig–Maximillian’s University in Munich between 2000 and 2002. The EP3 receptor expression was analyzed by immunohistochemistry and showed to have a significantly positive association with breast cancer prognosis for both entities, although with major differences. Patients with unifocal BC with EP3 receptor expression showed a significant improved overall survival, in contrast to the patient cohort with multifocal/multicentric BC. In this group, EP3 expression revealed its positive impact merely five years after initial diagnosis. Underlining the positive influence of EP3 as a positive prognosticator notably for unifocal breast cancer, only this patient cohort showed favorable outcomes in staging and grading. Especially EP3 expression in unifocal breast cancer was identified as an independent prognostic marker for the overall survival, when adjusted for age, grading, and staging. Altogether, our results strengthen the need to further investigate the behavior of EP3 in breast cancer and understand why markers linked to inflammation show different effects on prognosis and clinicopathological parameters on each focality type.
Collapse
Affiliation(s)
- Alaleh Zati Zehni
- Department of Obstetrics and Gynecology & Breast Center, University Hospital, Ludwig Maximilian University of Munich, Marchioninistraße 15, 81377 Munich, Germany; (A.Z.Z.); (A.H.); (T.K.); (N.D.); (S.M.)
| | - Udo Jeschke
- Department of Obstetrics and Gynecology & Breast Center, University Hospital, Ludwig Maximilian University of Munich, Marchioninistraße 15, 81377 Munich, Germany; (A.Z.Z.); (A.H.); (T.K.); (N.D.); (S.M.)
- Department of Obstetrics and Gynecology, University Hospital Augsburg, Universität Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany
- Correspondence: ; Tel.: +49-8214-0016-5505
| | - Anna Hester
- Department of Obstetrics and Gynecology & Breast Center, University Hospital, Ludwig Maximilian University of Munich, Marchioninistraße 15, 81377 Munich, Germany; (A.Z.Z.); (A.H.); (T.K.); (N.D.); (S.M.)
| | - Thomas Kolben
- Department of Obstetrics and Gynecology & Breast Center, University Hospital, Ludwig Maximilian University of Munich, Marchioninistraße 15, 81377 Munich, Germany; (A.Z.Z.); (A.H.); (T.K.); (N.D.); (S.M.)
| | - Nina Ditsch
- Department of Obstetrics and Gynecology & Breast Center, University Hospital, Ludwig Maximilian University of Munich, Marchioninistraße 15, 81377 Munich, Germany; (A.Z.Z.); (A.H.); (T.K.); (N.D.); (S.M.)
- Department of Obstetrics and Gynecology, University Hospital Augsburg, Universität Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany
| | - Sven-Niclas Jacob
- Department of General, Visceral, Transplant, Vascular and Thoracic Surgery, Ludwig Maximilian University of Munich, Marchioninistraße 15, 81377 Munich, Germany;
| | - Jan-Niclas Mumm
- Department of Urology, Ludwig Maximilian University of Munich, Marchioninistraße 15, 81377 Munich, Germany;
| | - Helene Hildegard Heidegger
- Department of Obstetrics and Gynecology & Breast Center, University Hospital, Ludwig Maximilian University of Munich, Maistraße 11, 80337 Munich, Germany; (H.H.H.); (T.V.)
| | - Sven Mahner
- Department of Obstetrics and Gynecology & Breast Center, University Hospital, Ludwig Maximilian University of Munich, Marchioninistraße 15, 81377 Munich, Germany; (A.Z.Z.); (A.H.); (T.K.); (N.D.); (S.M.)
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynecology & Breast Center, University Hospital, Ludwig Maximilian University of Munich, Maistraße 11, 80337 Munich, Germany; (H.H.H.); (T.V.)
| |
Collapse
|
31
|
Mumm JN, Osterman A, Ruzicka M, Stihl C, Vilsmaier T, Munker D, Khatamzas E, Giessen-Jung C, Stief C, Staehler M, Rodler S. Urinary Frequency as a Possibly Overlooked Symptom in COVID-19 Patients: Does SARS-CoV-2 Cause Viral Cystitis? Eur Urol 2020; 78:624-628. [PMID: 32475747 PMCID: PMC7236674 DOI: 10.1016/j.eururo.2020.05.013] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 05/12/2020] [Indexed: 01/21/2023]
Abstract
The current coronavirus disease 2019 (COVID-19) pandemic is a challenge for physicians in triaging patients in emergency rooms. We found a potentially dangerous overlap of classical urinary symptoms and the as yet not fully described symptoms of COVID-19. After a patient was primarily triaged as a urosepsis case and then subsequently diagnosed with COVID-19, we focused on an increase in urinary frequency as a symptom of COVID-19 and identified this in seven males out of 57 patients currently being treated in our COVID-19 wards. In the absence of any other causes, urinary frequency may be secondary to viral cystitis due to underlying COVID-19 disease. We propose consideration of urinary frequency as an anamnestic tool in patients with infective symptoms to increase awareness among urologists during the current COVID-19 pandemic to prevent fatal implications of misinterpreting urological symptoms.
Collapse
Affiliation(s)
- Jan-Niclas Mumm
- Klinik und Poliklinik für Urologie, Klinikum der Universität München, Munich, Germany.
| | - Andreas Osterman
- National Reference Center for Retroviruses, Max von Pettenkofer Institute and Gene Center, Faculty of Medicine, LMU München, Munich, Germany; German Center for Infection Research, Munich Partner Site, Munich, Germany
| | - Michael Ruzicka
- Medizinische Klinik III, Klinikum der Universität München, Munich, Germany
| | - Clemens Stihl
- Klink für Hals-Nasen-Ohren-Heilkunde, Klinikum der Universität München, Munich, Germany
| | - Theresa Vilsmaier
- Klink für Frauenheilkunde, Klinikum der Universität München, Munich, Germany
| | - Dieter Munker
- Medizinische Klinik V, Klinikum der Universität München, Munich, Germany
| | - Elham Khatamzas
- Medizinische Klinik III, Klinikum der Universität München, Munich, Germany
| | | | - Christian Stief
- Klinik und Poliklinik für Urologie, Klinikum der Universität München, Munich, Germany
| | - Michael Staehler
- Klinik und Poliklinik für Urologie, Klinikum der Universität München, Munich, Germany
| | - Severin Rodler
- Klinik und Poliklinik für Urologie, Klinikum der Universität München, Munich, Germany
| |
Collapse
|
32
|
Löb S, Vattai A, Kuhn C, Schmoeckel E, Mahner S, Wöckel A, Kolben T, Szekeres-Bartho J, Jeschke U, Vilsmaier T. Spliceosome protein EFTUD2 is upregulated in the trophoblast of spontaneous miscarriage and hydatidiform mole. J Reprod Immunol 2020; 140:103149. [PMID: 32447180 DOI: 10.1016/j.jri.2020.103149] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 01/23/2020] [Revised: 04/03/2020] [Accepted: 05/11/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Elongation factor Tu GTP binding domain containing 2 (EFTUD2) is an alternative splicing factor that modulates cell differentiation and activation processes. EFTUD2 is known to modulate immune responses and mutation of the EFTUD2-gene lead to fetal malformation. Little is known about its expression and role in normal and disturbed first trimester pregnancy. PATIENTS AND METHODS We investigated the expression of EFTUD2 in placental tissue obtained from patients with normal (n = 14), spontaneous miscarriage (n = 15) and molar (n = 14) pregnancy by immunohistochemistry. The expression of EFTUD2 was correlated on the protein level with known immune modulatory proteins like pregnancy zone protein (PZP) and in addition with human chorionic gonadotropin (hCG). Furthermore, we analysed the EFTUD2 and PZP expression in vitro after stimulation of the chorioncarcinoma cell line JEG-3 with hCG. RESULTS EFTUD2 is significantly upregulated in the syncytiotrophoblast of spontaneous miscarriage (p = 0.003) and molar pregnancy (p = 0.003) compared to week of gestation-adjusted normal first trimester placentas. PZP is negatively correlated (p = 0.021) to EFTUD2 in the syncytiotrophoblast and is therefore significantly downregulated in miscarriage (p = 0.028) and mole pregnancy (p = 0.006). In addition, hCG is positively correlated to EFTUD2 in mole pregnancy. The addition of hCG to chorioncarcinoma cell lines JEG-3 in vitro stimulated EFTUD2 expression in these cells (p = 0.027). CONCLUSION Regulation of alternative splicing seems crucial for a successful ongoing pregnancy. The up-regulated elongation factor EFTUD2 may have a critical role in miscarriage.
Collapse
Affiliation(s)
- Sanja Löb
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337,Munich, Germany; Department of Obstetrics and Gynecology, University Hospital, University of Wuerzburg, Josef-Schneider-Str. 4, 97080,Würzburg, Germany
| | - Aurelia Vattai
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337,Munich, Germany
| | - Christina Kuhn
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337,Munich, Germany
| | - Elisa Schmoeckel
- Department of Pathology, LMU Munich, Marchioninistr. 27, 81377,Munich, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337,Munich, Germany
| | - Achim Wöckel
- Department of Obstetrics and Gynecology, University Hospital, University of Wuerzburg, Josef-Schneider-Str. 4, 97080,Würzburg, Germany
| | - Thomas Kolben
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337,Munich, Germany
| | | | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337,Munich, Germany; Department of Obstetrics and Gynecology, University Hospital Augsburg, Stenglinstrasse 2, 86156,Augsburg, Germany.
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Maistrasse 11, 80337,Munich, Germany
| |
Collapse
|
33
|
Dietlmeier S, Ye Y, Kuhn C, Vattai A, Vilsmaier T, Schröder L, Kost BP, Gallwas J, Jeschke U, Mahner S, Heidegger HH. The prostaglandin receptor EP2 determines prognosis in EP3-negative and galectin-3-high cervical cancer cases. Sci Rep 2020; 10:1154. [PMID: 31980713 PMCID: PMC6981231 DOI: 10.1038/s41598-020-58095-3] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 01/02/2020] [Indexed: 12/24/2022] Open
Abstract
Recently our study identified EP3 receptor and galectin-3 as prognosticators of cervical cancer. The aim of the present study was the analysis of EP2 as a novel marker and its association to EP3, galectin-3, clinical pathological parameters and the overall survival rate of cervical cancer patients. Cervical cancer tissues (n = 250), as also used in our previous study, were stained with anti-EP2 antibodies employing a standardized immunohistochemistry protocol. Staining results were analyzed by the IRS scores and evaluated for its association with clinical-pathological parameters. H-test of EP2 percent-score showed significantly different expression in FIGO I-IV stages and tumor stages. Kaplan-Meier survival analyses indicated that EP3-negative/EP2-high staining patients (EP2 IRS score ≥2) had a significantly higher survival rate than the EP3-negative/EP2-low staining cases (p = 0.049). In the subgroup of high galectin-3 expressing patients, the group with high EP2 levels (IRS ≥2) had significantly better survival rates compared to EP2-low expressing group (IRS <2, p = 0.044). We demonstrated that the EP2 receptor is a prognostic factor for the overall survival in the subgroup of negative EP3 and high galectin-3 expressed cervical cancer patients. EP2 in combination with EP3 or galectin-3 might act as prognostic indicators of cervical cancer. EP2, EP3, and galectin-3 could be targeted for clinical diagnosis or endocrine treatment in cervical cancer patients, which demands future investigations.
Collapse
Affiliation(s)
- Sebastian Dietlmeier
- Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Campus Innenstadt, Munich, Germany
| | - Yao Ye
- Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Campus Innenstadt, Munich, Germany
| | - Christina Kuhn
- Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Campus Innenstadt, Munich, Germany
| | - Aurelia Vattai
- Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Campus Innenstadt, Munich, Germany
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Campus Innenstadt, Munich, Germany
| | - Lennard Schröder
- Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Campus Innenstadt, Munich, Germany
| | - Bernd P Kost
- Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Campus Innenstadt, Munich, Germany
| | - Julia Gallwas
- Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Campus Innenstadt, Munich, Germany
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Campus Innenstadt, Munich, Germany. .,Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Campus Großhadern, Munich, Germany.
| | - Sven Mahner
- Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Campus Innenstadt, Munich, Germany.,Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Campus Großhadern, Munich, Germany
| | - Helene Hildegard Heidegger
- Department of Obstetrics and Gynecology, LMU Munich, University Hospital, Campus Innenstadt, Munich, Germany
| |
Collapse
|
34
|
Schröder L, Marahrens P, Koch JG, Heidegger H, Vilsmaier T, Phan-Brehm T, Hofmann S, Mahner S, Jeschke U, Richter DU. [Corrigendum] Effects of green tea, matcha tea and their components epigallocatechin gallate and quercetin on MCF‑7 and MDA‑MB‑231 breast carcinoma cells. Oncol Rep 2020; 43:747. [PMID: 31894277 DOI: 10.3892/or.2019.7430] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 10/01/2018] [Indexed: 11/06/2022] Open
Abstract
Subsequently to the publication of this paper, the authors have realized that the name of the fifth listed author, Theresa Vilsmaier, was spelt incorrectly (it appeared as "Vilsmeier" in print). The corrected author list, as it shown have appeared in the paper, is shown above. The authors regret that the name of the fifth author on the paper was spelt incorrectly, and apologize to the readers for any inconvenience caused. [The original article was published in Oncology Reports 41: 387-396, 2019; DOI: 10.3892/or.2018.6789].
Collapse
Affiliation(s)
- Lennard Schröder
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University (LMU) of Munich, D-80337 Munich, Germany
| | - Philip Marahrens
- Department of Obstetrics and Gynecology, University of Rostock, D-18059 Rostock, Germany
| | - Julian G Koch
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University (LMU) of Munich, D-80337 Munich, Germany
| | - Helene Heidegger
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University (LMU) of Munich, D-80337 Munich, Germany
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University (LMU) of Munich, D-80337 Munich, Germany
| | - Thuy Phan-Brehm
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University (LMU) of Munich, D-80337 Munich, Germany
| | - Simone Hofmann
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University (LMU) of Munich, D-80337 Munich, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University (LMU) of Munich, D-80337 Munich, Germany
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilians University (LMU) of Munich, D-80337 Munich, Germany
| | - Dagmar U Richter
- Department of Obstetrics and Gynecology, University of Rostock, D-18059 Rostock, Germany
| |
Collapse
|
35
|
Wang Q, Schmoeckel E, Kost BP, Kuhn C, Vattai A, Vilsmaier T, Mahner S, Mayr D, Jeschke U, Heidegger HH. Higher CCL22+ Cell Infiltration is Associated with Poor Prognosis in Cervical Cancer Patients. Cancers (Basel) 2019; 11:cancers11122004. [PMID: 31842422 PMCID: PMC6966573 DOI: 10.3390/cancers11122004] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 11/20/2019] [Revised: 12/09/2019] [Accepted: 12/11/2019] [Indexed: 12/16/2022] Open
Abstract
The chemokine CCL22 recruits regulatory T (T-reg) cells into tumor tissues and is expressed in many human tumors. However, the prognostic role of CCL22 in cervical cancer (CC) has not been determined. This study retrospectively analyzed the clinical significance of the expression of CCL22 and FOXP3 in 230 cervical cancer patients. Immunohistochemical staining analyses of CCL22 and FOXP3 were performed with a tissue microarray. Double immunofluorescence staining, cell coculture, and ELISA were used to determine CCL22 expressing cells and mechanisms. The higher number of infiltrating CCL22+ cells (CCL22high) group was associated with lymph node metastasis (p = 0.004), Fédération Internationale de Gynécologie et d’Obstétrique (FIGO) stages (p = 0.010), therapeutic strategies (p = 0.007), and survival status (p = 0.002). The number of infiltrating CCL22+ cells was positively correlated with that of infiltrating FOXP3+ cells (r = 0.210, p = 0.001). The CCL22high group had a lower overall survival rate (OS), compared to the CCL22low group (p = 0.001). However, no significant differences in progression free survival (PFS) were noted between the two groups. CCL22high was an independent predictor of shorter OS (HR, 4.985; p = 0.0001). The OS of the combination group CCL22highFOXP3high was significantly lower than that of the combination group CCL22lowFOXP3low regardless of the FIGO stage and disease subtype. CCL22highFOXP3high was an independent indictor of shorter OS (HR, 5.284; p = 0.009). The PFS of group CCL22highFOXP3high was significantly lower than that of group CCL22lowFOXP3low in cervical adenocarcinoma, but CCL22highFOXP3high was not an independent indicator (HR, 3.018; p = 0.068). CCL22 was primarily expressed in M2-like macrophages in CC and induced by cervical cancer cells. The findings of our study indicate that cervical cancer patients with elevated CCL22+ infiltrating cells require more aggressive treatment. Moreover, the results provide a basis for subsequent, comprehensive studies to advance the design of immunotherapy for cervical cancer.
Collapse
Affiliation(s)
- Qun Wang
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 80377 Munich, Germany; (Q.W.); (B.P.K.); (C.K.); (A.V.); (T.V.); (S.M.); (H.H.H.)
| | - Elisa Schmoeckel
- Department of Pathology, LMU Munich, 80377 Munich, Germany; (E.S.); (D.M.)
| | - Bernd P. Kost
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 80377 Munich, Germany; (Q.W.); (B.P.K.); (C.K.); (A.V.); (T.V.); (S.M.); (H.H.H.)
| | - Christina Kuhn
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 80377 Munich, Germany; (Q.W.); (B.P.K.); (C.K.); (A.V.); (T.V.); (S.M.); (H.H.H.)
| | - Aurelia Vattai
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 80377 Munich, Germany; (Q.W.); (B.P.K.); (C.K.); (A.V.); (T.V.); (S.M.); (H.H.H.)
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 80377 Munich, Germany; (Q.W.); (B.P.K.); (C.K.); (A.V.); (T.V.); (S.M.); (H.H.H.)
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 80377 Munich, Germany; (Q.W.); (B.P.K.); (C.K.); (A.V.); (T.V.); (S.M.); (H.H.H.)
| | - Doris Mayr
- Department of Pathology, LMU Munich, 80377 Munich, Germany; (E.S.); (D.M.)
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 80377 Munich, Germany; (Q.W.); (B.P.K.); (C.K.); (A.V.); (T.V.); (S.M.); (H.H.H.)
- Correspondence:
| | - Helene Hildegard Heidegger
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 80377 Munich, Germany; (Q.W.); (B.P.K.); (C.K.); (A.V.); (T.V.); (S.M.); (H.H.H.)
| |
Collapse
|
36
|
Zati zehni A, Jacob SN, Mumm JN, Heidegger HH, Ditsch N, Mahner S, Jeschke U, Vilsmaier T. Hormone Receptor Expression in Multicentric/Multifocal versus Unifocal Breast Cancer: Especially the VDR Determines the Outcome Related to Focality. Int J Mol Sci 2019; 20:ijms20225740. [PMID: 31731733 PMCID: PMC6888644 DOI: 10.3390/ijms20225740] [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] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 11/12/2019] [Indexed: 12/21/2022] Open
Abstract
The aim of this study was to evaluate the prognostic impact that hormone receptor (HR) expressions have on the two different breast cancer (BC) entities—multifocal versus unifocal BC. As the prognosis determining aspects, we investigated the overall survival (OS) and disease-free survival (DFS) by univariate and multivariate analysis. To underline the study’s conclusions, we additionally considered the histopathological grading and the tumor node metastasis (TNM) staging. A retrospective analysis was performed on survival-related events in a series of 320 breast cancer patients treated at the Department of Gynecology and Obstetrics at the Ludwig Maximillian University in Munich between 2000 and 2002. All three steroid receptors analyzed by immunohistochemistry, namely, the estrogen receptor (ER), the progesterone receptor (PR), and the vitamin D receptor (VDR), showed a significantly positive influence on the course of the disease, but only for the unifocal breast tumor patients. The prognosis of patients with multifocal breast cancer was either not affected by estrogen and/or progesterone receptor expression or even involved a worse etiopathology for the vitamin D receptor-positive patients. The estrogen receptor in unifocal breast cancer and the vitamin D receptor in multifocal breast cancer were especially identified as an independent prognostic marker for overall survival, when adjusted for age, grading, and staging. Altogether, our results strengthen the need to further investigate the behavior of the hormone receptors in breast cancer and understand why they have different effects on each focality type. Moreover, the studies for an adopted vitamin D supplementation due to breast cancer focality type must be enlarged to fully comprehend the remarkable and interesting role played by the vitamin D receptor.
Collapse
Affiliation(s)
- Alaleh Zati zehni
- Department of Obstetrics and Gynecology, Ludwig Maximilian University of Munich (LMU), Maistraße 11, 80337 Munich, Germany (H.H.H.); (S.M.); (T.V.)
| | - Sven-Niclas Jacob
- Department of General, Visceral, Transplant, Vascular and Thoracic Surgery, LMU, Marchioninistraße 15, 81377 Munich, Germany;
| | - Jan-Niclas Mumm
- Department of Urology, LMU Munich, University Hospital, Marchioninistraße 15, 81377 Munich, Germany;
| | - Helene Hildegard Heidegger
- Department of Obstetrics and Gynecology, Ludwig Maximilian University of Munich (LMU), Maistraße 11, 80337 Munich, Germany (H.H.H.); (S.M.); (T.V.)
| | - Nina Ditsch
- Department of Obstetrics and Gynecology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany;
| | - Sven Mahner
- Department of Obstetrics and Gynecology, Ludwig Maximilian University of Munich (LMU), Maistraße 11, 80337 Munich, Germany (H.H.H.); (S.M.); (T.V.)
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, Ludwig Maximilian University of Munich (LMU), Maistraße 11, 80337 Munich, Germany (H.H.H.); (S.M.); (T.V.)
- Department of Obstetrics and Gynecology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany;
- Correspondence: ; Tel.: +49-8214-0016-5505
| | - Theresa Vilsmaier
- Department of Obstetrics and Gynecology, Ludwig Maximilian University of Munich (LMU), Maistraße 11, 80337 Munich, Germany (H.H.H.); (S.M.); (T.V.)
| |
Collapse
|
37
|
Vilsmaier T, Kästner R, Alba-Alejandre I. Hundert Jahre Geburtshilfe am Beispiel der Jahre 1917 und 2017 in der I. Frauenklinik der Universität München. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671467] [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
|
38
|
Mumm JN, Klehr B, Kretschmer A, Vilsmaier T, Schulz G, Gozzi C, Rehder P, May F, Homberg R, Gebhartl P, Stief C, Bauer R. PD39-11 48-MONTH DATA FOR THE ADVANCE XP® MALE SLING IN THE THERAPY OF MALE URINARY INCONTINENCE: RESULTS OF A PROSPECTIVE MULTICENTRE STUDY. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
39
|
Vilsmaier T, Rack B, König A, Friese K, Janni W, Jeschke U, Weissenbacher T. Influence of Circulating Tumour Cells on Production of IL-1α, IL-1β and IL-12 in Sera of Patients with Primary Diagnosis of Breast Cancer Before Treatment. Anticancer Res 2017; 36:5227-5236. [PMID: 27798883 DOI: 10.21873/anticanres.11093] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 03/15/2016] [Accepted: 09/20/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Circulating tumour cells (CTCs) have been found to be a prognostic marker for reduced disease-free survival (DFS), distant DFS, breast cancer-specific survival, and overall survival (OS) before the start of systemic treatment. Determination of CTCs with the CellSearch System (Veridex, Raritan, NJ, USA) is a valuable but time-consuming and costly method. Therefore, the aim of this study was to evaluate cytokine profiles as a marker for CTC involvement. PATIENTS AND METHODS Patients chosen for this study were defined as women with breast cancer who agreed to participate in the phase I SUCCESS study. CTC analysis, the blood sampling time points, and the methodology were prospectively designed, and the prognostic value of the CTCs was defined as a scientific objective of the study protocol. A total of 100 patients positive for CTCs and an additional 100 patients negative for CTCs were matched into pairs. Matching criteria were histopathological grading, lymph node status, hormone receptor type, TNM classification and survival vs. tumour associated death. Commercial enzyme-linked immunosorbent assay (ELISA) was used to screen the blood serum samples for the Th1 cytokines: interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin 12 (IL-12), IL-1α, IL-1β, IL-2 and IL-18. The correlation of cytokine levels to the matching criteria listed above were analyzed with the Spearman correlation coefficient and the Mann-Whitney-U rank-sum test. RESULTS The IL-1α level was significantly lower in the CTC-positive patient group (p=0.043) but significantly higher in the CTC-negative progesterone receptor-positive collective (p=0.029). Furthermore, in patients who survived, significantly higher IL-12p40 levels were found in those with lymph node involvement (p=0.041) and those with triple-negative breast cancer (p=0.043). Of patients who died, those with oestrogen receptor-negative disease had higher IL-1α (p=0.050) and higher IL-1β (p=0.034) levels. Moreover, of those who died, those with triple-negative breast cancer had significantly higher IL-1α levels (p=0.033). In patients with grade 2 tumour, patients with HER2/neu expression had significantly higher IFN-γ levels (p=0.031) and those with no lymph node involvement had significantly higher IL-1α levels (p=0.014). In the collective with grade 3 tumour, patients with progesterone receptor-negative disease had significantly higher IL12p70 concentrations (p=0.048), while those with triple-negative breast cancer had lower IL12p40 levels (p=0.033). CONCLUSION Regarding CTC involvement, we speculate that IL-1α might be a marker for the release of tumour cells into the circulation and not into the lymphatic system. In addition, IL-1α like IL-1β appears to be related to CTC release in patients with breast cancer.
Collapse
Affiliation(s)
- Theresa Vilsmaier
- Department of Gynecology and Obstetrics, Ludwig Maximilian University, Munich, Germany
| | - Brigitte Rack
- Department of Gynecology and Obstetrics, Ludwig Maximilian University, Munich, Germany
| | - Alexander König
- Department of Gynecology and Obstetrics, Ludwig Maximilian University, Munich, Germany
| | - Klaus Friese
- Department of Gynecology and Obstetrics, Ludwig Maximilian University, Munich, Germany
| | - Wolfgang Janni
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Udo Jeschke
- Department of Gynecology and Obstetrics, Ludwig Maximilian University, Munich, Germany
| | - Tobias Weissenbacher
- Department of Gynecology and Obstetrics, Ludwig Maximilian University, Munich, Germany
| | | |
Collapse
|
40
|
Vilsmaier T, Rack B, Janni W, Jeschke U, Weissenbacher T. Angiogenic cytokines and their influence on circulating tumour cells in sera of patients with the primary diagnosis of breast cancer before treatment. BMC Cancer 2016; 16:547. [PMID: 27464822 PMCID: PMC4964055 DOI: 10.1186/s12885-016-2612-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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: 11/02/2015] [Accepted: 07/25/2016] [Indexed: 12/05/2022] Open
Abstract
Background Circulating tumour cells (CTCs) have been found to be a prognostic marker for reduced disease free survival, breast cancer–specific survival, and overall survival before the start of systemic treatment. Methods A total of 200 patients’ sera were included in this study, 100 patients being CTC positive and 100 patients being CTC negative. Matching criteria were histo-pathological grading, lymph node metastasis, hormone receptor status, TNM classification and survived breast cancer patients vs. deceased tumor associated patients. A multi cytokine/chemokine array was used to screen the sera for the angiogenic markers. Results Statistical significant correlation was exposed for sFlt1 values in regard to the CTC-Status. CTC negative patients displayed increased sFlt1 expression opposed to CTC positive breast cancer patients. Furthermore, significant enhanced PIGF values were also disclosed in CTC negative patients compared to patients being CTC positive. Analyzing the living patient collective we found significant differences in sFlt1 and PlGF values in regard to CTC negative and CTC positive patients. Conclusion Both vascular markers showed enhanced expression in the CTC negative patient collective. To continue, the collective graded G2 showed significantly enhanced sFlt1 expressions amongst patients with no CTCs. Moreover, the patient collective with no lymph node metastasis and CTC negativity indicated statistically significant increased sFlt1 values. A functional interaction of sFlt1 and PlGF was found, suggesting that their overexpression in tumour cells inhibits CTCs entering the peripheral blood. Furthermore, in regard to CTC negativity, sFlt1 and PlGF values may potentially serve as predictive markers. Trial registration The TRN of this study is NCT02181101 and the date of registration was the 4th of June 2014. The study was retrospectively registered.
Collapse
Affiliation(s)
- Theresa Vilsmaier
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-University of Munich, Maistrasse 11, 80337, Munich, Germany
| | - Brigitte Rack
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-University of Munich, Maistrasse 11, 80337, Munich, Germany
| | - Wolfgang Janni
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-University of Munich, Maistrasse 11, 80337, Munich, Germany.
| | - Tobias Weissenbacher
- Department of Obstetrics and Gynecology, Ludwig-Maximilians-University of Munich, Maistrasse 11, 80337, Munich, Germany
| | | |
Collapse
|
41
|
König A, Vilsmaier T, Rack B, Friese K, Janni W, Jeschke U, Andergassen U, Trapp E, Jückstock J, Jäger B, Alunni-Fabbroni M, Friedl T, Weissenbacher T. Determination of Interleukin-4, -5, -6, -8 and -13 in Serum of Patients with Breast Cancer Before Treatment and its Correlation to Circulating Tumor Cells. Anticancer Res 2016; 36:3123-3130. [PMID: 27272837] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 05/11/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND/AIM Circulating tumor cells (CTCs) in women with breast cancer are an indication of prognosis before starting systemic treatment. The aim of this study was the evaluation of cytokine profiles as marker for CTC involvement. MATERIALS AND METHODS The analysis of CTCs, the time of blood sampling and the methodology were prospectively designed. There were two groups of patients: 100 women with a positive result for presence of CTCs and 100 women negative for CTCs. These groups were matched into pairs by tumor factors and survival/death. A multi-array ELISA was used to screen T-helper cell (Th) 2 cytokines. The results were analyzed by Spearman correlation coefficient and Mann-Whitney U-test. RESULTS In patients who were CTC-negative, expression of interleukin-8 (IL-8) and IL-13 was increased (p=0.017 and p=0.045, respectively) if they were negative for progesterone receptor. In patients who died from their tumor, correlation between hormone receptor negativity and an increase in IL-4 was found. IL-5 was increased in patients with lymph node-positive and human epidermal growth factor receptor 2 (HER2)-positive disease (p=0.042). Moreover IL-4 was increased in patients with progesterone receptor-positive and estrogen receptor-negative status (p=0.024). Furthermore, the level of IL-6 was increased in patients with tumor grade G3 without progesterone receptor expression. CONCLUSION Th2 cytokines are significantly modified in patients who are CTC-negative and progesterone receptor-positive. We suppose that an increase of IL-4 depends on hormone receptor status. In literature, a correlation between IL-4 and resistance to apoptosis is described. We suspect that IL-4 is responsible for the poor outcome of these cases.
Collapse
Affiliation(s)
- Alexander König
- Department of Gynecology and Obstetrics, Ludwig Maximilians University, Munich, Germany
| | - Theresa Vilsmaier
- Department of Gynecology and Obstetrics, Ludwig Maximilians University, Munich, Germany
| | - Brigitte Rack
- Department of Gynecology and Obstetrics, Ludwig Maximilians University, Munich, Germany
| | - Klaus Friese
- Department of Gynecology and Obstetrics, Ludwig Maximilians University, Munich, Germany
| | - Wolfgang Janni
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Udo Jeschke
- Department of Gynecology and Obstetrics, Ludwig Maximilians University, Munich, Germany
| | - Ulrich Andergassen
- Department of Gynecology and Obstetrics, Ludwig Maximilians University, Munich, Germany
| | - Elisabeth Trapp
- Department of Gynecology and Obstetrics, Ludwig Maximilians University, Munich, Germany
| | - Julia Jückstock
- Department of Gynecology and Obstetrics, Ludwig Maximilians University, Munich, Germany
| | - Bernadette Jäger
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | | | - Thomas Friedl
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Tobias Weissenbacher
- Department of Gynecology and Obstetrics, Ludwig Maximilians University, Munich, Germany
| |
Collapse
|