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Güralp O, Acikgöz S, Tüten N, Ekmekci H, Schild-Suhren M, Malik E, Tüten A. Evaluation of Serum Endocan Levels in Endometriosis: A case-control study. Clin Ter 2021; 171:e517-e522. [PMID: 33151250 DOI: 10.7417/ct.2020.2266] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the possible associations between serum endocan levels and endometriosis. STUDY DESIGN A total of 60 women with histologically proven endometriosis and 40 women who underwent laparoscopy due to unexplained infertility without endometriosis were evaluated in a case-control study. Serum endocan, CA125, CA19.9, and CA15.3 levels were measured. Demographic, clinical, and laboratory parameters were compared. RESULTS There was no significant difference between the groups regarding age, body-mass-index, parity, and serum CRP and WBC levels. Serum endocan (p<0.001), CA125 (p<0.001), CA19.9 (p=0.022) and CA15.3 (p=0.013) levels were significantly higher in the endometriosis group compared to the control group. The correlation analysis showed that serum endocan level was positively correlated with the stage of the disease, CRP, and WBC, but not with remaining parameters, age, BMI, dysmenorrhea score, CA125, CA19.9, and CA15.3. Serum CA125 can predict endometriosis (Cut off=26.2 IU/mL, AUC=0.955) with a sensitivity of 89% and specificity of 88%. Serum endocan can predict endometriosis (Cut off=454 ng/mL AUC=0.749) with a 93% sensitivity and 61% specificity. CONCLUSIONS The serum endocan levels were significantly elevated in women with endometriosis compared to the control group. Serum endocan can predict endometriosis with a sensitivity of 93% and specificity of 61.
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Affiliation(s)
- O Güralp
- Carl von Ossietzky Oldenburg University, Department of Obstetrics and Gynecology, Klinikum Oldenburg, Oldenburg, Germany
| | - S Acikgöz
- Istanbul Cerrahpasa University, Department of Obstetrics and Gynecology, Istanbul, Turkey
| | - N Tüten
- Kanuni Sultan Suleyman Education and Research Hospital, Obstetrics and Gynecology, Atakent Mahallesi, Halkalı Altınşehir İstanbul Cd. Istanbul, Turkey
| | - H Ekmekci
- Istanbul Cerrahpasa University, Department of Biochemistry, Kocamustafapasa Cad. Istanbul, Turkey
| | - M Schild-Suhren
- Carl von Ossietzky Oldenburg University, Department of Obstetrics and Gynecology, Klinikum Oldenburg, Oldenburg, Germany
| | - E Malik
- Carl von Ossietzky Oldenburg University, Department of Obstetrics and Gynecology, Klinikum Oldenburg, Oldenburg, Germany
| | - A Tüten
- Istanbul Cerrahpasa University, Department of Obstetrics and Gynecology, Istanbul, Turkey
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Soliman A, Ortmann O, Inwald E, Güralp O, Arvas M, Malik E. VEGR1, VEGR2 und HIF-1α als Biomarker für Lymphknotenbefall beim endometrioiden Hochrisikoendometriumkarzinom. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- A Soliman
- Carl von Ossietzky Universität Oldenburg, Universitätsklinik für Gynäkologie und Geburtshilfe, Oldenburg, Deutschland
| | - O Ortmann
- Universität Regensburg, Universitätsklinik für Gynäkologie und Geburtshilfe, Regensburg, Deutschland
| | - E Inwald
- Universität Regensburg, Universitätsklinik für Gynäkologie und Geburtshilfe, Regensburg, Deutschland
| | - O Güralp
- Carl von Ossietzky Universität Oldenburg, Universitätsklinik für Gynäkologie und Geburtshilfe, Oldenburg, Deutschland
| | - M Arvas
- Universität Istanbul, Universitätsklinik für Gynäkologie und Geburtshilfe, Istanbul, Türkei
| | - E Malik
- Carl von Ossietzky Universität Oldenburg, Universitätsklinik für Gynäkologie und Geburtshilfe, Oldenburg, Deutschland
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Güralp O, Kaya B, Daglar K, Soliman A, Malik E. Bilaterale Ligatur der A. iliaca interna als alleinige Therapie oder in Kombination mit anderen uteruserhaltenden Techniken bei Therapie resistenter postpartaler Blutung. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- O Güralp
- Universitätsklinik für Gynäkologie und Geburtshilfe, Klinikum Oldenburg AöR, Fakultät für Medizin und Gesundheitswissenschaften, Universität Oldenburg, Gynäkologie und Geburtshilfe, Oldenburg, Deutschland
| | - B Kaya
- Near East University, Gynäkologie und Geburtshilfe, Mersin, Türkei
- Gaziantep Geburtsklinik, Gynäkologie und Geburtshilfe, Gaziantep, Türkei
| | - K Daglar
- Gaziantep Geburtsklinik, Gynäkologie und Geburtshilfe, Gaziantep, Türkei
- Zekai Tahir Burak Lehrkrankenhaus, Gynäkologie und Geburtshilfe, Ankara, Deutschland
| | - A Soliman
- Universitätsklinik für Gynäkologie und Geburtshilfe, Klinikum Oldenburg AöR, Fakultät für Medizin und Gesundheitswissenschaften, Universität Oldenburg, Gynäkologie und Geburtshilfe, Oldenburg, Deutschland
| | - E Malik
- Universitätsklinik für Gynäkologie und Geburtshilfe, Klinikum Oldenburg AöR, Fakultät für Medizin und Gesundheitswissenschaften, Universität Oldenburg, Gynäkologie und Geburtshilfe, Oldenburg, Deutschland
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Schild-Suhren M, Soliman A, Malik E. Adenokarzinom und Plattenepithelkarzinom der Zervix in der Schwangerschaft: Zwei Falldarstellungen. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- M Schild-Suhren
- Universitätsklinik Oldenburg, Gynäkologie und Geburtshilfe, Oldenburg, Deutschland
| | - A Soliman
- Universitätsklinik Oldenburg, Gynäkologie und Geburtshilfe, Oldenburg, Deutschland
| | - E Malik
- Universitätsklinik Oldenburg, Gynäkologie und Geburtshilfe, Oldenburg, Deutschland
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Soliman A, Mostafa S, Refky B, Malik E. Lymphadenectomy and pelvic irradiation in high-risk endometrioid endometrial cancer: A population-based retrospective analysis using the SEER databank. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- A Soliman
- Carl von Ossietzky Universität Oldenburg, Klinikum Oldenburg AöR, Universitätsklinik für Gynäkologie und Geburtshilfe, Oldenburg, Deutschland
| | - S Mostafa
- University of Indiana, Department of Statistics, Bloomington, Vereinigte Staaten von Amerika
| | - B Refky
- University of Mansura, Faculty of Medicine, Oncology Center, Department of Surgical Oncology, Mansura, Ägypten
| | - E Malik
- Carl von Ossietzky Universität Oldenburg, Klinikum Oldenburg AöR, Universitätsklinik für Gynäkologie und Geburtshilfe, Oldenburg, Deutschland
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Soliman A, Elzarka A, Malik E. Peritoneal cancer index as a predictor of survival in advanced stage serous epithelial ovarian cancer: A prospective study. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- A Soliman
- Fakultät für Medizin und Gesundheitswissenschaften Carl von Ossietzky Universität Oldenburg, Universitätsklinik für Gynäkologie und Geburtshilfe, Klinikum Oldenburg AöR, Oldenburg, Deutschland
| | - A Elzarka
- University of Alexandria, Faculty of Medicine, Obstetrics and Gynecology, Alexandria, Ägypten
| | - E Malik
- Fakultät für Medizin und Gesundheitswissenschaften Carl von Ossietzky Universität Oldenburg, Universitätsklinik für Gynäkologie und Geburtshilfe, Klinikum Oldenburg AöR, Oldenburg, Deutschland
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Habendorf W, Henke RP, Kowald T, Malik E, Banz-Jansen C. Multilokuläres Adenosarkom des Uterus einer 19-jährigen Frau: Ein Fallbericht und Überblick der aktuellen Literatur. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- W Habendorf
- Universitätsklinik für Gynäkologie und Geburtshilfe, Klinikum Oldenburg AöR, Fakultät für Medizin und Gesundheitswissenschaften, Universität Oldenburg, Gynäkologie und Geburtshilfe, Oldenburg, Deutschland
| | - RP Henke
- Institut für Pathologie Oldenburg, Pathologie, Oldenburg, Deutschland
| | - T Kowald
- Institut für Diagnostische & Interventionelle Radiologie, Klinikum Oldenburg, Radiologie, Oldenburg, Deutschland
| | - E Malik
- Universitätsklinik für Gynäkologie und Geburtshilfe, Klinikum Oldenburg AöR, Fakultät für Medizin und Gesundheitswissenschaften, Universität Oldenburg, Gynäkologie und Geburtshilfe, Oldenburg, Deutschland
| | - C Banz-Jansen
- Universitätsklinik für Gynäkologie und Geburtshilfe, Klinikum Oldenburg AöR, Fakultät für Medizin und Gesundheitswissenschaften, Universität Oldenburg, Gynäkologie und Geburtshilfe, Oldenburg, Deutschland
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Faivre E, Coelho JE, Zornbach K, Malik E, Baqi Y, Schneider M, Cellai L, Carvalho K, Sebda S, Figeac M, Eddarkaoui S, Caillierez R, Chern Y, Heneka M, Sergeant N, Müller CE, Halle A, Buée L, Lopes LV, Blum D. Beneficial Effect of a Selective Adenosine A 2A Receptor Antagonist in the APPswe/PS1dE9 Mouse Model of Alzheimer's Disease. Front Mol Neurosci 2018; 11:235. [PMID: 30050407 PMCID: PMC6052540 DOI: 10.3389/fnmol.2018.00235] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [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: 04/25/2018] [Accepted: 06/15/2018] [Indexed: 02/06/2023] Open
Abstract
Consumption of caffeine, a non-selective adenosine A2A receptor (A2AR) antagonist, reduces the risk of developing Alzheimer’s disease (AD) and mitigates both amyloid and Tau lesions in transgenic mouse models of the disease. While short-term treatment with A2AR antagonists have been shown to alleviate cognitive deficits in mouse models of amyloidogenesis, impact of a chronic and long-term treatment on the development of amyloid burden, associated neuroinflammation and memory deficits has never been assessed. In the present study, we have evaluated the effect of a 6-month treatment of APPsw/PS1dE9 mice with the potent and selective A2AR antagonist MSX-3 from 3 to 9-10 months of age. At completion of the treatment, we found that the MSX-3 treatment prevented the development of memory deficits in APP/PS1dE9 mice, without significantly altering hippocampal and cortical gene expressions. Interestingly, MSX-3 treatment led to a significant decrease of Aβ1-42 levels in the cortex of APP/PS1dE9 animals, while Aβ1-40 increased, thereby strongly affecting the Aβ1-42/Aβ1-40 ratio. Together, these data support the idea that A2AR blockade is of therapeutic value for AD.
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Affiliation(s)
- Emilie Faivre
- Université de Lille, Inserm, CHU-Lille, LabEx DISTALZ, Jean-Pierre Aubert Research Centre UMR-S1172, Alzheimer & Tauopathies, Lille, France
| | - Joana E Coelho
- Instituto de Medicina Molecular, Faculdade de Medicina de Lisboa, Universidade de Lisboa, Lisbon, Portugal
| | - Katja Zornbach
- Center of Advanced European Studies and Research, Bonn, Germany
| | - Enas Malik
- PharmaCenter Bonn, Pharmaceutical Institute, Pharmaceutical Chemistry I, University of Bonn, Bonn, Germany
| | - Younis Baqi
- PharmaCenter Bonn, Pharmaceutical Institute, Pharmaceutical Chemistry I, University of Bonn, Bonn, Germany.,Department of Chemistry, Faculty of Science, Sultan Qaboos University, Muscat, Oman
| | - Marion Schneider
- PharmaCenter Bonn, Pharmaceutical Institute, Pharmaceutical Chemistry I, University of Bonn, Bonn, Germany
| | - Lucrezia Cellai
- Université de Lille, Inserm, CHU-Lille, LabEx DISTALZ, Jean-Pierre Aubert Research Centre UMR-S1172, Alzheimer & Tauopathies, Lille, France
| | - Kevin Carvalho
- Université de Lille, Inserm, CHU-Lille, LabEx DISTALZ, Jean-Pierre Aubert Research Centre UMR-S1172, Alzheimer & Tauopathies, Lille, France
| | - Shéhérazade Sebda
- Plateau de Génomique Fonctionnelle et Structurale, CHU Lille, University of Lille, Lille, France
| | - Martin Figeac
- Plateau de Génomique Fonctionnelle et Structurale, CHU Lille, University of Lille, Lille, France
| | - Sabiha Eddarkaoui
- Université de Lille, Inserm, CHU-Lille, LabEx DISTALZ, Jean-Pierre Aubert Research Centre UMR-S1172, Alzheimer & Tauopathies, Lille, France
| | - Raphaëlle Caillierez
- Université de Lille, Inserm, CHU-Lille, LabEx DISTALZ, Jean-Pierre Aubert Research Centre UMR-S1172, Alzheimer & Tauopathies, Lille, France
| | - Yijuang Chern
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Michael Heneka
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Neurodegenerative Diseases and Geropsychiatry/Neurology, University of Bonn Medical Center, Bonn, Germany
| | - Nicolas Sergeant
- Université de Lille, Inserm, CHU-Lille, LabEx DISTALZ, Jean-Pierre Aubert Research Centre UMR-S1172, Alzheimer & Tauopathies, Lille, France
| | - Christa E Müller
- PharmaCenter Bonn, Pharmaceutical Institute, Pharmaceutical Chemistry I, University of Bonn, Bonn, Germany
| | - Annett Halle
- Center of Advanced European Studies and Research, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Luc Buée
- Université de Lille, Inserm, CHU-Lille, LabEx DISTALZ, Jean-Pierre Aubert Research Centre UMR-S1172, Alzheimer & Tauopathies, Lille, France
| | - Luisa V Lopes
- Instituto de Medicina Molecular, Faculdade de Medicina de Lisboa, Universidade de Lisboa, Lisbon, Portugal
| | - David Blum
- Université de Lille, Inserm, CHU-Lille, LabEx DISTALZ, Jean-Pierre Aubert Research Centre UMR-S1172, Alzheimer & Tauopathies, Lille, France
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Yadav D, Agarwal S, Sharma A, Malik E, Kandasamy D, Thakar A, Yadav R, Barward A, Kini L. Synovial sarcoma masquerading as medullary thyroid carcinoma. Cytopathology 2018; 29:468-470. [PMID: 29873853 DOI: 10.1111/cyt.12582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2018] [Indexed: 11/29/2022]
Affiliation(s)
- D Yadav
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - S Agarwal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - A Sharma
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - E Malik
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - D Kandasamy
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - A Thakar
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, New Delhi, India
| | - R Yadav
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - A Barward
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - L Kini
- Clinical Pathologist, CORE Diagnostics, New Delhi, India
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Abstract
Background Although silicone breast implants are well tolerated, local complications such as capsular contracture occur because of insufficient integration with surrounding tissues. In this study, cell behaviour on hydrophilized silicone breast implant foils was analysed qualitatively and quantitatively under in vitro conditions in order to provoke the desired responses in a defined environment. Methods Silicone breast implant foils with different surface modifications were tested after 24 hours, 5 days and 7 days. The following modifications of silicone implant foils were tested: Unmodified silicone, silicone after-graft polymerisation for polyacrylic acid (pAAc), silicone-pAAc-fibronectin adsorptive, silicone-pAAC-fibronectin covalent, positive and negative controls. Experiments were conducted using cell culture with murine mouse fibroblasts L-929. Cytotoxicity assays were carried out in direct and indirect contact with cells grown on the material. For the viability test and qualitative analysis of cell proliferation on different foils, both fluoresceine-diacetate and ethidiumbromide were used and in addition the morphologic description of hemalaun-stained cells were used. Quantitative cell analysis was carried out using XTT after resuspension. Results Toxic influence on cell cultures could be excluded for coated and uncoated surfaces in contact with dissolved biomaterials. Unmodified silicone surfaces showed poor cell growth in direct contact. We found a gradual improvement of cell morphology, with the spread and proliferation depending on the type of surface modification. Better results were achieved with covalently coupled fibronectin and GRGDS than with pAAc. Conclusion Covalent immobilisation of hydrophobic silicone rubber can improve the initial cellbiomaterial interactions that are required to aid the successful development of tissue-like structures.
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Affiliation(s)
- W Siggelkow
- Department of Obstetrics and Gynecology, University of Aachen, Germany.
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Kaya B, Usluogullari B, Yurttutan N, Sahan M, Güralp O, Malik E. Does ligation of internal iliac artery for postpartum hemorrhage affect clitoral artery blood flow and postpartum sexual functions? Eur J Obstet Gynecol Reprod Biol 2017; 219:124-128. [DOI: 10.1016/j.ejogrb.2017.10.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 10/23/2017] [Accepted: 10/30/2017] [Indexed: 10/18/2022]
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Abstract
BACKGROUND AND OBJECTIVES Primary hyperparathyroidism (PHPT) can occur either as a sporadic case or in association with syndromes such as multiple endocrine neoplasia. Multiple endocrine neoplasia type 1 (MEN1) is a rare autosomal-dominant disease resulting from mutations in MEN1 gene encoding a 621 amino acid long tumor suppressor protein "menin." We report here the results of MEN1 screening in 31 patients diagnosed with sporadic PHPT. MATERIALS AND METHODS Diagnosis of sporadic PHPT was made when blood urea and serum creatinine were normal, serum parathyroid hormone was high, and parathyroid enlargement could be localized on ultrasound and/or parathyroid scan. A total of 31 patients and 50 healthy volunteers were recruited for molecular analysis after taking informed consent. RESULTS Major symptoms at presentation were bone pain, fatigue, muscle weakness, and renal stones. Molecular genetic analysis revealed the presence of two novel intronic variations, c. 913-79T>A and c. 784-129T>A which by human splicing finder are predicted to cause potential alteration of splicing by either activating an intronic cryptic acceptor site or converting a conserved exonic splicing silencer sequence to an exonic splicing enhancer site. Apart from these, two reported polymorphisms rs144677807 and rs669976 were seen only in patients and none of the controls. Other reported polymorphisms rs2071313 and rs654440 were identified both in controls and patients. CONCLUSIONS This is the first study of MEN1 gene screening in sporadic PHPT in India reporting on the clinical and genetic findings, wherein two novel intronic variations c. 913-79T>A and c. 784-129T>A were identified showing their possible role in disease causation.
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Affiliation(s)
- S Birla
- Laboratory of Cyto-Molecular Genetics, Department of Anatomy, AIIMS, New Delhi, India
| | - E Malik
- Laboratory of Cyto-Molecular Genetics, Department of Anatomy, AIIMS, New Delhi, India
| | - VP Jyotsna
- Department of Endocrinology and Metabolism, AIIMS, New Delhi, India
| | - A Sharma
- Laboratory of Cyto-Molecular Genetics, Department of Anatomy, AIIMS, New Delhi, India
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Peles E, Sason A, Malik E, Schreiber S, Adelson M. Characteristics and outcome of methadone maintenance treatment (MMT) patients with depression. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.1065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroductionComorbidity of depression and opioid addiction is highly prevalent, but their outcome in MMT is not consistent.ObjectivesTo compare between depressed and non-depressed MMT patients.MethodsHamilton depression scale scores (taken during a psychiatric assessment) were studied among MMT patients on admission or during treatment (cutoff for depression > 18).ResultsA total of 498 MMT patients were studied. Depression proportion was 22.5%, and 23.2% among 263 who were studied on admission; the depressed vs. non-depressed on admission did not differ in female proportion (19.7% vs. 25.6%), age of admission (43.2 ± 10.4), opiate use onset (21.8 ± 6.3) and education years (9.5 ± 2.8), but had higher proportion of cocaine (55.7% vs. 35.1%, P = 0.005), and benzodiazepine abuse (73.8% vs. 58.4%, P = 0.04). Retention was high and similar (80.3 vs. 82.9% P = 0.7) and of those who stayed one year, cocaine and benzodiazepine were still higher among the depressed patients (cocaine: 43.8% vs. 23.2%, P = 0.03; BDZ: 61.2% vs. 40%, P = 0.01). Compared to the non-depressed, among all study group (n = 498) the depressed patients presented higher proportion of rape history (25% vs. 9.5%, P = 0.001), of suicide attempts (43.8% vs. 25%, P = 0.001) with only a trend of shorter cumulative retention in MMT of mean 9.4y (95% CI 7.8–10.7) vs. 11.5 (95% CI 10.5–12.5, P = 0.07).ConclusionDespite cocaine and benzodiazepine abuse on admission, depressed succeeded similarly to the non-depressed in the first year retention in treatment. Intervention is recommended since admission, as their long-term retention seems to be shorter, later on, and their ability to discontinue cocaine and benzodiazepine abuse is clearly hampered.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Laurent C, Burnouf S, Ferry B, Batalha VL, Coelho JE, Baqi Y, Malik E, Marciniak E, Parrot S, Van der Jeugd A, Faivre E, Flaten V, Ledent C, D'Hooge R, Sergeant N, Hamdane M, Humez S, Müller CE, Lopes LV, Buée L, Blum D, Blum D. A2A adenosine receptor deletion is protective in a mouse model of Tauopathy. Mol Psychiatry 2016. [PMID: 26216297 DOI: 10.1038/mp.2015.115] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Lüdders DW, Henke RP, Saba M, Raddatz L, Soliman A, Malik E. Severe Maternal Pre- and Postpartum Intra-Abdominal Bleeding due to Deciduosis. Geburtshilfe Frauenheilkd 2015; 75:259-262. [PMID: 25914420 DOI: 10.1055/s-0035-1545876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 02/08/2015] [Accepted: 02/10/2015] [Indexed: 10/23/2022] Open
Abstract
The term "deciduosis" is used to describe the severe pregnancy-associated occurrence of ectopic decidua with a usually asymptomatic course. We report on two cases of massive maternal intra-abdominal bleeding due to such symptomatic changes. The complications arose at different time points for the two cases: prepartum (26th week of pregnancy) or, respectively, - reported here for the first time - seven days postpartum. As well as differential diagnostic aspects we describe the management of the disease and its possible effects on subsequent pregnancies.
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Affiliation(s)
- D W Lüdders
- Department of Obstetrics and Gynaecology, University Hospital Oldenburg, Oldenburg
| | - R-P Henke
- University Hospital Oldenburg, Institute for Pathology, Oldenburg
| | - M Saba
- Department of Obstetrics and Gynaecology, University Hospital Oldenburg, Oldenburg
| | - L Raddatz
- Department of Obstetrics and Gynaecology, University Hospital Oldenburg, Oldenburg
| | - A Soliman
- Department of Obstetrics and Gynaecology, University Hospital Oldenburg, Oldenburg
| | - E Malik
- Department of Obstetrics and Gynaecology, University Hospital Oldenburg, Oldenburg
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Lüdders DW, Saba M, Raddatz LM, Henke P, Malik E. Prä- und postpartale abdominelle Blutungen aufgrund einer Deziduose – zwei Fallberichte. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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El Sony AI, Chiang CY, Malik E, Hassanain SA, Hussien H, Khamis AH, Bassilli AF, Enarson DA. Standard case management of asthma in Sudan: a pilot project. Public Health Action 2013; 3:247-52. [PMID: 26393039 PMCID: PMC4463127 DOI: 10.5588/pha.13.0019] [Citation(s) in RCA: 11] [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: 04/07/2013] [Accepted: 07/14/2013] [Indexed: 11/10/2022] Open
Abstract
SETTING A pilot project for asthma management in selected hospitals in Khartoum and Gezira States, Sudan. OBJECTIVE To assess standard case management of asthma in 2007-2008. DESIGN Local adaptation of guidelines, followed by situational analysis, pre-intervention study, training and implementation. Treatment outcome was assessed 1 year after patient enrolment. RESULTS Situational analysis revealed that inhaled beclometasone was not available in the public sector. During the project, 2068 patients were enrolled: severity of asthma was intermittent in 185 (9.0%), mild persistent in 231 (11.2%), moderate persistent in 640 (31.0%), severe persistent in 812 (39.3%) and unclassified in 200 (9.7%). Of the 1654 patients with persistent asthma who were treated with inhaled corticosteroids, 1157 (70.0%) had treatment cards available for outcome assessment. Of these, 652 (56.4%) did not attend their annual evaluation, among whom 1 (0.1%) died and 651 (56.3%) were lost to follow-up. Of the 505 patients who attended their annual evaluation, 417 (82.6%) improved, 32 (6.3%) were stable and 56 (11.1%) were worse. The frequency of emergency visits and hospitalisation decreased substantially among those who presented for the 1 year follow-up assessment. CONCLUSION The results of standard case management of asthma were encouraging; however, a high proportion of patients did not return for long-term management.
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Affiliation(s)
| | - C-Y Chiang
- International Union Against Tuberculosis and Lung Disease, Paris, France ; Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan ; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - E Malik
- Ministry of Health, Madani, Gezira State, Sudan
| | | | | | - A H Khamis
- Epi-Lab, Khartoum, Sudan ; Department of Family and Community Medicine, University of Dammam, Khobar, Saudi Arabia
| | - A F Bassilli
- World Health Organization, Eastern Mediterranean Regional Office, Cairo, Egypt
| | - D A Enarson
- International Union Against Tuberculosis and Lung Disease, Paris, France
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Ufen M, Rosien B, Hammer T, Schubert U, Malik E, Kohne C. Survival of metastatic breast cancer (MBC): Is there a survival benefit over time? J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e21062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Shefet D, Gerstein O, Leubov Y, Malik E, Marom M, Shapiro Rotman M, Shapir L, Shmuel T. The use of antidepressants for bipolar depression. Isr J Psychiatry Relat Sci 2011; 48:136-137. [PMID: 22120450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Clinical Dilemma: You have diagnosed a 33-year-old male with bipolar disorder and initiated lithium treatment and psycho-social therapy. Two months later his lithium level is within the therapeutic range but his symptoms and function level correlate with moderate depressive episode. Is there a place for adjunctive antidepressant medication?
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Malik E, Meyhöfer-Malik A, Trutenau D, Diddens H, Küpker W, Diedrich K. Pilotstudie zur photodynamischen Diagnostik der Endometriose mittels 5-Aminolävulinsäure. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2007-1022737] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Malik E, Stoz F, Möbus V, Kreienberg R. Subkostaler Einstich in der Medioklavikularlinie zur primären Insufflation und Inspektion im Rahmen der gynäkologischen Laparoskopie. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2007-1023104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Juhasz-Böss I, Treeck O, Ortmann O, Malik E. Progesteroneffekt auf den Gefäßflächen- und Gefäßdichteindex des ektopen Endometriums von Patientinnen mit und ohne Endometriose auf der Chorioallantoismembran. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-983618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Stimmler P, Juhasz-Böss I, Piso P, Malik E, Ortmann O. Endometriose des Zwerchfells. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Juhasz-Böss I, Staede A, Treeck O, Ortmann O, Malik E. Zyklische Expression von Vascular Endothelial Growth Factor (VEGF), Angiopoetin 1 und 2 im Endometrium. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-924466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Janssen P, Herrmanns B, Schelling M, Malik E, Bartz C. Die Deziduose - eine seltene lebensbedrohliche Komplikation in der Schwangerschaft. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-924311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Rund D, Krichevsky S, Bar-Cohen S, Goldschmidt N, Kedmi M, Malik E, Gural A, Shafran-Tikva S, Ben-Neriah S, Ben-Yehuda D. Therapy-related leukemia: clinical characteristics and analysis of new molecular risk factors in 96 adult patients. Leukemia 2005; 19:1919-28. [PMID: 16167058 DOI: 10.1038/sj.leu.2403947] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Therapy-related leukemia or myelodysplasia (t-leuk/MDS) is a serious problem that is increasing in frequency. We studied the clinical characteristics of 96 patients (pts) with a mean age of 48 years, and analyzed the molecular parameters that could predispose to t-leuk/MDS. Hematological malignancies were the most common primary (53%), followed by breast and ovarian cancer (30% combined). The mean latency until the development of t-AML was 45.5 months. Median survival was 10 months. Cytogenetics was abnormal in 89% of pts. FLT3 internal tandem duplications were found in six of 41 (14.6%) pts, of whom four had an abnormal karyotype. Analysis of drug metabolism and disposition genes showed a protective effect of the CYP3A4 1*B genotype against the development of t-leuk/MDS, whereas the CC genotype of MDR1 C3435T and the NAD(P)H:quinone oxidoreductase1 codon 187 polymorphism were both noncontributory. Microsatellite instability (MSI) analysis using fluoresceinated PCR with ABI sequence analyzer demonstrated that 41% of pts had high levels of MSI in four or more of 10 microsatellite loci. Immunohistochemistry demonstrated reduced expression of MSH2 and MLH1 in 6/10 pts with MSI as compared to 0/5 of pts without MSI. In conclusion, genetic predisposition as well as epigenetic events contribute to the etiology of t-AML/MDS.
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Affiliation(s)
- D Rund
- Department of Hematology, Hadassah University Hospital, Jerusalem, Israel.
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Juhasz-Böss I, Meyhöfer-Malik A, Ortmann O, Malik E. Gefäßflächenindex (GFI) und Gefäßdichteindex (GDI) des Endometriums von Patientinnen mit und ohne Endometriose auf der Chorioallantoismembran (CAM). Geburtshilfe Frauenheilkd 2005. [DOI: 10.1055/s-2005-920849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Gescher DM, Siggelkow W, Meyhoefer-Malik A, Malik E. A priori implantation potential does not differ in eutopic endometrium of patients with and without endometriosis. Arch Gynecol Obstet 2004; 272:117-23. [PMID: 15986219 DOI: 10.1007/s00404-004-0688-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2004] [Accepted: 08/30/2004] [Indexed: 01/10/2023]
Abstract
BACKGROUND In endometriosis, angiogenesis is a crucial step for implantation of the exfoliates. A priori potential to induce angiogenesis by vascular endothelial growth factor (VEGF) expression was compared in eutopic endometrium of patients with and without endometriosis to discriminate the pivotal pathogenic step that differs in endometriosis. METHODS In an experimental prospective study, endometrium samples were obtained from endometriosis patients (n=10) and from healthy, ovulating women as controls (n=6) undergoing curettage and laparoscopy for benign gynaecological conditions at the Aachen University Hospital, Aachen, Germany. Endometrial fragments were transplanted to the chicken chorioallantoic membrane (CAM) and re-explanted after 0, 24, 48, 72 and 96 h of cultivation for analysis. The main outcome measure was VEGF mRNA expression and protein localisation in endometrial fragments as parameters of angiogenic induction that was quantified by the vessel index. RESULTS VEGF mRNA expression increased significantly in endometrial fragments of endometriosis and control patients (p<0.05). Protein is expressed in the glands and endometrial stroma. The vessel index is significantly elevated compared with native CAM controls. Endometrial fragments of endometriosis and control patients showed no significant differences in VEGF expression or angiogenic induction. CONCLUSIONS Eutopic endometrial fragments of patients with and without endometriosis do not differ in their VEGF expression or angiogenic activity in the CAM assay. Implantation is obviously decided by external regulating influences on the exfoliates.
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Affiliation(s)
- D M Gescher
- Institute of Microbiology and Hygiene, Charité, Humboldt University, 10117, Berlin, Germany.
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Noack F, Schmidt H, Buchweitz O, Malik E, Horny HP. Genomic imbalance and onco-protein expression of ovarian endometrioid adenocarcinoma arisen in an endometriotic cyst. Anticancer Res 2004; 24:151-4. [PMID: 15015590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND Malignant transformation in endometriosis is a rare but well known complication. However, detailed mechanisms of malignant transition and tumourigenesis in endometriosis remain unknown. We here describe the case of an endometrioid carcinoma arisen in endometriotic ovarian cyst fulfilling Sampson's criteria for malignant transformation of endometriosis. We compared genetic alterations and oncoprotein expression in the endometriotic ovarian cyst and the associated endometrioid adenocarcinoma. MATERIALS AND METHODS Genomic instability was evaluated by comparative genomic hybridization (CGH). Onco-protein expression was analysed by immunohistochemistry with antibodies against bcl-2, c-MYC, cyclin D1, p53, HER-2 and KIT protein. RESULTS CGH revealed a gain of 8q, including the locus of the oncogene c-MYC at 8q24. Immunohistochemistry disclosed a differing protein expression profile between the epithelia of the pre-existing cyst and adenocarcinoma. Apart from HER-2, all onco-proteins were more strongly expressed in epithelial cells of the adenocarcinoma than of the endometriotic cyst. CONCLUSION The solitary genomic imbalance of chromosome 8 possibly reflects the importance for initiation and/or progression of endometrioid carcinoma. Overexpression of onco-proteins then may occur subsequently in the malignant transformation of ovarian endometriosis. However, the exact mechanisms of malignant transition in ovarian endometriosis remain to be elucidated in future studies with a higher number of cases.
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Affiliation(s)
- F Noack
- Department of Pathology, University Hospital Lübeck, Germany.
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Abstract
The pathogenesis of endometriosis is dependent on implantation. Therefore, angiogenesis of the ectopic endometrium is discussed as a crucial step in the development of an endometriotic lesion. It is not only the main condition for implantation, but also a parameter for the clinical activity of endometriosis. Pigmented and non-pigmented endometriotic lesions differ according to their clinical activity and angiogenic potential. Using a model system of endometriosis, the chorioallantoic membrane assay, mRNA expression of VEGF and matrix metalloproteinases 1 and 2 was analysed. As the most representative angiogenic factors, they were correlated to the angiogenic reaction on the CAM by the vessel index. We assume that angiogenic activity of ectopic endometrium is a condition sine qua non for the pathogenesis of endometriosis, but is regulated by different other factors.
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Affiliation(s)
- D M Gescher
- Frauenklinik für Gynäkologie und Geburtshilfe, Universitätsklinikum der RWTH Aachen
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Andersen CA, Meyhöfer-Malik A, Gescher DM, Hermanns B, Rath W, Malik E. Die Expression angiogenetischer Faktoren beim Ovarialkarzinom. Geburtshilfe Frauenheilkd 2003. [DOI: 10.1055/s-2003-815224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Gescher DM, Meyhöfer-Malik A, Rath W, Malik E. Angiogenese und m-RNA-Expression der Matrix Metalloproteinasen (MMP) 1 und 2 im ektopen Endometrium auf der Chorioallantoismembran (CAM). Geburtshilfe Frauenheilkd 2003. [DOI: 10.1055/s-2003-815263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Malik E, Gescher DM, Meyhöfer-Malik A, Roos J, Rath W. Untersuchungen zum Faktor VIII und Gefäßdichteindex bei Patientinnen mit und ohne Endometriose. Geburtshilfe Frauenheilkd 2003. [DOI: 10.1055/s-2003-815127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Buchweitz O, Poel T, Diedrich K, Malik E. The diagnostic dilemma of minimal and mild endometriosis under routine conditions. J Am Assoc Gynecol Laparosc 2003; 10:85-9. [PMID: 12555000 DOI: 10.1016/s1074-3804(05)60240-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
STUDY OBJECTIVE To evaluate the reliability of diagnosing minimal and mild endometriosis under routine conditions, and to determine to what extent disease activity is taken into account. DESIGN Retrospective analysis (Canadian Task Force classification II-2). SETTING University teaching hospital. INTERVENTION Laparoscopy. PATIENTS One hundred eighteen consecutive women with minimal and mild endometriosis undergoing routine surgery between 1994 and 1999. MEASUREMENTS AND MAIN RESULTS Analytic parameters were the total number of endometriotic lesions; intraoperative description of pigmented, nonpigmented, and nondefined lesions; and number of extirpated lesions and histologic detection rate. In 118 patients, 311 suspected endometriotic lesions were documented. Nonpigmented lesions were reported in only 27% of women. In 51% of surgical reports no importance was attached to disease morphology or activity. Only 1.2 biopsies/patient were taken. The histologic detection rate was 56%. In 49 patients the assumed intraoperative diagnosis was confirmed by histologic examination. CONCLUSIONS Intraoperative description of endometriotic lesions is inadequate. Little attention is paid to the activity of the illness. There is room for improvement in the number of excisions and histologic detection, and an attempt should be made to find a way out of this diagnostic dilemma.
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Affiliation(s)
- O Buchweitz
- Department of Gynaecology and Obstetrics, University of Muenster, Albert-Schweitzer-Strasse 33, 48149 Muenster, Germany
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Abstract
We did a retrospective survey of 83 patients who had laparoscopic removal of a benign dermoid cyst in our hospital since 1994. Preoperative transvaginal sonography led to the correct diagnosis in 57 cases (69%). In 59 cases cystectomy with ovarian conservation was performed; spillage of cyst contents occurred in 39 cases (66%). Salpingo-oophorectomy was performed in 24 patients with spillage in 8 cases (24%). The mean tumor size (n=83) was 4.5+/-1.6 cm and 4.9+/-2.8 cm for unspilled and spilled cysts, respectively. The tumor was placed in an endobag in 62 cases. No intra- or postoperative complications occurred. No case of chemical peritonitis was noted.
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Affiliation(s)
- C Berg
- Department of Obstetrics and Gynecology, Medical University of Luebeck, Lübeck, Germany.
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Abstract
Endometriosis is an oestrogen-dependent disease that is treatable by oestrogen withdrawal, a therapy that has been effectively provided by the use of a gonadotrophin-releasing hormone (GnRH) agonist. Complete oestrogen withdrawal results in unacceptable side-effects, in particular in accelerated bone density loss. This problem has been effectively overcome with 'add-back therapy' using low-dose oestrogens and progestins in combination with a GnRH agonist to limit these side-effects, while still allowing regression of endometriotic lesions. The aim of this study was to determine the feasibility of using a subcutaneous injection of GnRH antagonist in the treatment of endometriosis. All patients (15/15; 100%) reported a symptom-free period during GnRH antagonist treatment, including mood changes, hot flushes, loss of libido, vaginal dryness and other symptoms. Serum oestradiol oscillated around a mean concentration of 50 pg/ml during therapy. Diagnostic laparoscopy before GnRH antagonist administration showed a mean stage III of disease. Regression occurred in 60% of cases (9/15) and the degree of endometriosis declined to stage II. Sequential administration of the GnRH antagonist cetrorelix (Cetrotide) in a 3 mg dosage once weekly over 8 weeks creates a new opportunity for medical treatment of symptomatic endometriosis. Preserving basic oestrogen production during the course of treatment apparently does not influence regression of disease, and has no major side-effects.
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Affiliation(s)
- W Küpker
- Department of Obstetrics and Gynaecology, Medical University Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany.
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Kressin P, Wolber EM, Wodrich H, Meyhöfer-Malik A, Buchweitz O, Diedrich K, Malik E. Vascular endothelial growth factor mRNA in eutopic and ectopic endometrium. Fertil Steril 2001; 76:1220-4. [PMID: 11730754 DOI: 10.1016/s0015-0282(01)02898-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To evaluate changes in expression levels of vascular endothelial growth factor (VEGF) mRNA in human endometrial explants in a chicken chorioallantoic membrane model of endometriosis. DESIGN Experimental prospective study. SETTING University hospital. PATIENT(S) Endometrial biopsy samples were obtained from healthy, ovulating women undergoing elective surgery. INTERVENTION(S) Endometrial fragments were placed on the chicken chorioallantoic membrane and removed for analysis after 0, 24, 48, and 72 hours. MAIN OUTCOME MEASURE(S) Expression of different VEGF mRNA splice variants was tested. Expression of VEGF(165) mRNA was assessed by using competitive polymerase chain reaction and normalized to expression of the housekeeping gene human glyceraldehyde 3-phosphate dehydrogenase (GAPDH) mRNA. RESULT(S) After 0, 24, 48, and 72 hours of incubation, all grafts expressed VEGF(121), VEGF(145), VEGF(165), and VEGF(189) mRNA. Expression of VEGF(165) mRNA increased up to 10-fold at 24 to 72 hours compared with precultivation values. CONCLUSION(S) Levels of VEGF(165) mRNA in endometrial grafts increase after implantation on chicken chorioallantoic membrane. Hypoxic induction of VEGF mRNA expression in endometrial cell cultures has been reported previously. Induction of VEGF expression might indicate relative hypoxia of the specimen due to insufficient vascularization. Expression of VEGF may assist in vascularization of endometrial explants after retrograde menstruation.
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Affiliation(s)
- P Kressin
- Department of Obstetrics and Gynecology, Medical University of Lübeck, Lübeck, Germany.
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Malik E, Buchweitz O, Müller-Steinhardt M, Kressin P, Meyhöfer-Malik A, Diedrich K. Prospective evaluation of the systemic immune response following abdominal, vaginal, and laparoscopically assisted vaginal hysterectomy. Surg Endosc 2001; 15:463-6. [PMID: 11353962 DOI: 10.1007/s004640000348] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2000] [Accepted: 08/09/2000] [Indexed: 01/10/2023]
Abstract
BACKGROUND Alterations in serum levels of cytokine interleukin-6 (IL-6) and acute-phase protein C-reactive protein (CRP) correlate directly with extent of tissue damage and inflammatory reaction. We therefore prospectively compared the postoperative levels of IL-6 and CRP following abdominal (AH), vaginal (VH), and laparoscopically assisted vaginal hysterectomy (LAVH). METHODS A total of 29 patients were included in the study (10 VH, 10 LAVH, 9 AH). Nine blood samples were taken from each patient at various time points before, during, and after surgery. CRP and IL-6 were measured under standardized conditions using ELISA and turbidometry. RESULTS Preoperative levels of IL-6 and CRP were low in all three patient groups. There was a significant increase in the IL-6 level in patients undergoing AH at the time of peritoneal closure that reached a maximum 2 h postoperatively and remained significantly elevated for 12 h postoperatively when compared to the IL-6 levels of patients undergoing VH or LAVH (p < 0.05). The levels of the IL-6 time courses differed significantly among the three operative procedures (p = 0.013). In contrast, the levels of the CRP time courses did not differ significantly (p = 0.066); however, CRP expression was elevated 36 h postoperatively in patients undergoing AH, as compared with those undergoing VH. CONCLUSION Elevated IL-6 levels subsequent to AH may reflect significantly greater tissue damage in these patients than in patients who undergo VH or LAVH. LAVH should therefore be considered in cases that cannot be managed by the vaginal route alone.
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Affiliation(s)
- E Malik
- Department of Obstetrics and Gynecology, Medical University of Luebeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany
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Buchweitz O, Malik E, Kressin P, Meyhoefer-Malik A, Diedrich K. Laparoscopic management of tubo-ovarian abscesses: retrospective analysis of 60 cases. Surg Endosc 2000; 14:948-50. [PMID: 11080409 DOI: 10.1007/s004640000249] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The laparoscopic management of tubo-ovarian abscesses (TOA) was evaluated. The study sought to answer the following question: Does operative laparoscopy with only incision of the abscess cavity and lavage (organ-preserving treatment) improve intraoperative and postoperative safety and long-term prospects of fertility as compared with laparoscopic salpingectomy or salpingo-oophorectomy (ablative treatment)? METHODS A retrospective chart review of 60 patients with TOA undergoing laparoscopic treatment in combination with broad-spectrum antibiotics from 1994 to 1998 was performed. Patients not wishing to have children underwent salpingectomy or salpingo-oophorectomy, whereas patients wishing to remain fertile were treated by means of an organ-preserving procedure. To investigate the operative and reproductive outcome, patients were interviewed by telephone. RESULTS Of 60 women with TOA, 25 were treated laparoscopically, preserving the internal genital organs, and 35 underwent ablative treatment. Apart from one postoperative readmission because of lower pelvic pain in the organ-preserving group, there were no operative complications or serious systemic sequelae. In contrast, there was a significantly higher incidence of intraoperative and postoperative complications when ablative treatment was performed: one intestinal perforation requiring subsequent laparotomy, four serosal lesions, two lesions of the greater omentum, two lacerated collaterals of the internal iliac artery, one postoperative fever higher than 38 degrees C for 2 days, two bowel obstructions, one thrombosis of the upper leg, and one thrombosis of the lower leg. There were no significant differences between the two patient groups in body mass index, duration of pelvic pain, laboratory findings at admission, ultrasonic assessment of abscess size, and the extent of the abscess at laparoscopy. CONCLUSIONS When laparoscopic treatment of TOA is performed, organ-preserving treatment should be chosen irrespective of the patient's age or desire to have children because of the risk of complications.
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Affiliation(s)
- O Buchweitz
- Departement of Gynaecology and Obstetrics, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany
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Malik E, Berg C, Sterzik K, Stoz F, Rossmanith WG. Reproductive outcome of 32 patients with primary or secondary infertility and uterine pathology. Arch Gynecol Obstet 2000; 264:24-6. [PMID: 10985614 DOI: 10.1007/pl00007477] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We did a retrospective study on 102 patients who had a laparoscopy and a hysteroscopy during investigations for primary or secondary infertility. 32 of the 102 patients had uterine pathology. Seven of them had septate uteri, eight had uterine synechiae, another six had uterine fibroids, four had a bicornuated uterus, while the remaining had either a combination of all or other uterine anomalies. After surgical treatment of these conditions ten women conceived and five pregnancies including one twin pregnancy resulted in term deliveries.
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Affiliation(s)
- E Malik
- Department of Obstetrics and Gynecology, Medical University Lübeck, Germany
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Abstract
BACKGROUND The diagnosis of nonpigmented endometrial lesions by simple laparoscopic visualization is difficult and often inaccurate. We therefore sought to establish a new and more accurate method to visualize these nonpigmented peritoneal changes caused by endometriosis. METHODS A total of 37 patients received 30 mg 5-aminolevulinic acid/kg body weight 10 to 14 hs prior to surgery. Laparoscopy was then performed using a D-light system (Storz, Tuttlingen, Germany). The findings were evaluated first in the white-light mode; the D-light system was then activated, and all areas of fluorescence were documented. Multiple specimens were obtained by biopsy. RESULTS The sensitivity of the fluorescence diagnosis in detecting endometriosis in nonpigmented areas and normal-looking peritoneum is 100%, with a specificity of 75%. Diagnosis by simple visualization under white illumination has a sensitivity of only 69% and a specificity of 70%. Occult areas of endometriosis were discovered using fluorescence diagnosis. CONCLUSIONS Our findings suggest that fluorescence diagnosis using 5-aminolevulinic acid is feasible and can improve the diagnosis of endometriosis in nonpigmented and occult endometrial lesions. Fluorescence diagnosis is a promising new tool in the diagnosis of endometriosis.
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Affiliation(s)
- E Malik
- Department of Obstetrics and Gynecology, Medical University Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany
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Malik E, Meyhöfer-Malik A, Berg C, Böhm W, Kunzi-Rapp K, Diedrich K, Rück A. Fluorescence diagnosis of endometriosis on the chorioallantoic membrane using 5-aminolaevulinic acid. Hum Reprod 2000; 15:584-8. [PMID: 10686200 DOI: 10.1093/humrep/15.3.584] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The chorioallantoic membrane (CAM) is a useful model for the fluorescence diagnosis of experimentally induced endometriosis. In our experimental setup 75.7% of the histologically examined tissue preparations were viable and only 24.3% showed signs of necrosis on the CAM after various periods of incubation. Best results were obtained when grafting to the CAM was performed between days 7 and 9 and when implants were left on the CAM for 3-5 days (P < 0.05). We were able to demonstrate that 5-aminolaevulinic acid (ALA) is stored selectively in ectopic endometrium. The subsequent fluorescence of the endometrium shows a rapid increase that reaches a peak after 10-14 h which can be clearly differentiated from the weaker fluorescence of grafted normal peritoneum and fimbriae (P < 0.01).
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Affiliation(s)
- E Malik
- Department of Obstetrics and Gynaecology, Medical University Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany
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Malik E, Berg C, Meyhöfer-Malik A, Haider S, Rossmanith WG. Subjective evaluation of the therapeutic value of laparoscopic adhesiolysis: a retrospective analysis. Surg Endosc 2000; 14:79-81. [PMID: 10653243 DOI: 10.1007/s004649900017] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Adhesions are believed to be one of the principal causes of chronic pelvic pain. Although there may be some discrepancy between the degree of adhesions and the severity of the symptoms, surgical adhesiolysis is still considered to be useful for the relief of pain. METHODS A total of 187 patients who underwent laparoscopic adhesiolysis at the Medical University of Ulm, Germany, within a 2-year period were asked to rank their discomfort on a visual pain scale before surgery and up to 1 1/2 years postoperatively. RESULTS In this retrospective study, we found that nearly one-third of patients suffered from functional irritations that were either ameliorated or completely relieved by laparoscopic adhesiolysis. When other causes of chronic pain (such as endometriosis) are excluded, the results show that most patients benefited from laparoscopic adhesiolysis. CONCLUSIONS It appears that laparoscopic adhesiolysis is an effective therapeutic measure to relieve chronic pelvic pain. Therefore, adhesiolysis should be performed in all patients with chronic or intermittent pain, and a complete lysis of adhesions should be planned. However, since pelvic pain may have organic or functional causes other than adhesions, complete adhesiolysis in patients with persistent pelvic pain may be of only limited importance.
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Affiliation(s)
- E Malik
- Department of Obstetrics and Gynecology, Medical University of Lübeck, Germany
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Malik E, Berg C, Meyhöfer-Malik A, Diedrich K. Angiogene Aktivität der Douglasflüssigkeit von Patientinnen mit Endometriose nach oraler Applikation von 5-Aminolävulinsäure. Geburtshilfe Frauenheilkd 1999. [DOI: 10.1055/s-1999-15639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Kressin P, Wolber E, Meyhöfer-Malik A, Diedrich K, Malik E. O-033. A modified chorioallantoic membrane (CAM) assay for testing anti-angiogenic strategies in a model of experimentally induced endometriosis. Hum Reprod 1999. [DOI: 10.1093/humrep/14.suppl_3.18-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Malik E, Böhme W, Nitsch C, Rossmanith WG. Gibt es prä- und intraoperative Kriterien zur Vermeidung des laparoskopischen „Anoperierens” von frühen Ovarialkarzinomen oder Borderline-Tumoren? Geburtshilfe Frauenheilkd 1999. [DOI: 10.1055/s-1999-14152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Abstract
BACKGROUND Laparoscopy can be used with minimal operative morbidity to evaluate adnexal masses. We report our experience with the endoscopic approach to the diagnosis and treatment of ovarian tumors. In particular, we describe 11 patients who incidentally underwent laparoscopy and in whom the ovarian masses were found to be malignant. METHODS Between September 1994 and September 1996, 292 patients with 316 ovarian tumors were treated laparoscopically in the Department of Obstetrics-Gynaecology, University of Ulm. We assessed vaginal ultrasonography, clinical assessment, the tumor marker CA 12-5, and the intraoperative low-power magnification for their value in predicting the final diagnosis in all laparoscopically treated ovarian tumors. RESULTS From a total of 292 patients with ovarian tumors, 11 were diagnosed, intraoperatively or after final histologic examination, as having a malignant or borderline ovarian tumor. All applied pre- and intraoperative diagnostic procedures were by themselves too unreliable to exclude early stages of ovarian carcinoma exactly. CONCLUSIONS On the basis of the present findings, we are tempted to conclude that laparoscopic surgery is justified in the management of ovarian tumors. Even with an accurate preoperative selection of suitable patients for laparoscopic surgery, the presence of an undetected ovarian carcinoma cannot be entirely excluded.
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Affiliation(s)
- E Malik
- Department of Obstetrics and Gynecology, University of Ulm, Prittwitzstr. 43, D-89070 Ulm, Germany
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Malik E, Schmidt M, Scheidel P. [Complications after 106 laparoscopic hysterectomies]. Zentralbl Gynakol 1998; 119:611-5. [PMID: 9483812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
At our hospital in Hamburg 106 patients underwent laparoscopic hysterectomies. 92 patients had no complications, but 6 had major and 10 minor ones. As major complications occurred: one vesico-vaginal fistula, one uretero-vaginal fistula, one ureter injury, one lesion of the small intestine and two bladder injuries. As minor complications could be found: six urinary tract infections, one anemia (Hb 7,1 g/dl) and one febrile morbidity. The overall complication rate is 13.2%.
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Affiliation(s)
- E Malik
- Universitäts-Frauenklinik Lübeck
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