Access to Hysterectomy-What Is the Realistic Rate for Pure Vaginal Hysterectomy? A Single-Center Prospective Observational Study.

Hysterectomy (HE) is the most common surgical procedure in gynecology worldwide. The guidelines of most countries unanimously recommend vaginal hysterectomy (VH) as the access of first choice. However, there are significant international differences in the implementation of this recommendation.

Growing in generosity? The effects of giving magnitude, target, and audience on the neural signature of giving in adolescence.

Giving is essential for forming and maintaining social relationships, which is an important developmental task for adolescents. This pre-registered fMRI study investigated behavioral and neural correlates of adolescents' (N = 128, ages 9 - 19 years) small versus large size giving in different social contexts related to target (i.e.

Happy for Us not Them: Differences in neural activation in a vicarious reward task between family and strangers during adolescent development.

During adolescence social-interactions with other people become more relevant. One key aspect of these interactions is cooperative behavior. Cooperation relies on a set of cognitive and affective mechanisms.

I am happy for us: Neural processing of vicarious joy when winning for parents versus strangers.

This study investigated the neural processes underlying vicarious joy and their dependence on emotional closeness. Prior studies revealed that the nucleus accumbens (NAcc) is a target brain region for processing rewards for self, but the neural mechanisms of processing rewards for others are not yet well understood. A functional magnetic resonance imaging (fMRI) paradigm was employed in young adults (N = 30), in combination with a self-report questionnaire on the perceived emotional closeness to the target.

Genetic and environmental influences on functional connectivity within and between canonical cortical resting-state networks throughout adolescent development in boys and girls.

The human brain is active during rest and hierarchically organized into intrinsic functional networks. These functional networks are largely established early in development, with reports of a shift from a local to more distributed organization during childhood and adolescence. It remains unknown to what extent genetic and environmental influences on functional connectivity change throughout adolescent development.

Resting state functional connectivity patterns associated with pharmacological treatment resistance in temporal lobe epilepsy.

There are no functional imaging based biomarkers for pharmacological treatment response in temporal lobe epilepsy (TLE). In this study, we investigated whether there is an association between resting state functional brain connectivity (RsFC) and seizure control in TLE. We screened a large database containing resting state functional magnetic resonance imaging (Rs-fMRI) data from 286 epilepsy patients.

Wavelet analysis techniques in cavitating flows.

Cavitating and bubbly flows involve a host of physical phenomena and processes ranging from nucleation, surface and interfacial effects, mass transfer via diffusion and phase change to macroscopic flow physics involving bubble dynamics, turbulent flow interactions and two-phase compressible effects. The complex physics that result from these phenomena and their interactions make for flows that are difficult to investigate and analyse. From an experimental perspective, evolving sensing technology and data processing provide opportunities for gaining new insight and understanding of these complex flows, and the continuous wavelet transform (CWT) is a powerful tool to aid in their elucidation.

Indications and Route of Hysterectomy for Benign Diseases. Guideline of the DGGG, OEGGG and SGGG (S3 Level, AWMF Registry No. 015/070, April 2015).

Official guideline "indications and methods of hysterectomy" to assign indications for the different methods published and coordinated by the German Society of Gynecology and Obstetrics (DGGG), the Austrian Society of Gynecology and Obstetrics (OEGGG) and the Swiss Society of Gynecology and Obstetrics (SGGG). Besides vaginal and abdominal hysterectomy, three additional techniques have been implemented due to the introduction of laparoscopy. Organ-sparing alternatives were also integrated.

Hysteroscopic resection of submucous myomas.

Within just a few years, operative hysteroscopy has largely replaced laparotomy in the treatment of submucous myomas. Due to the rapid expansion of hysteroscopic surgery techniques, guidelines must be defined to standardize the procedure and at the same time provide the basis for highly individualized treatment of each patient. The choice of an appropriate therapeutic approach in this context is an issue of logistics, rather than surgery.

Tamoxifen-induced hyperplasia of the endometrium.

Greatly thickened endometria are often observed in vaginal sonography in patients taking tamoxifen. The incidence of type I carcinoma of the endometrium is also raised under tamoxifen. Both effects are ascribed to the known partial estrogenic effect of tamoxifen.

Diagnosis of endometrial cancer and its precursors.

Whereas cervical carcinoma is reliably detectable by the noninvasive methods of cytological/cervical smear and HPV typing even in the early stages, endometrial carcinoma thus far eludes effective check-up. Neither ultrasound nor invasive procedures such as Pipelle de Cornier, abrasio fracta or hysteroscopy, succeeded in making the majority of endometrial carcinomas detectable at an early stage in systematic screenings. Several factors contribute to this fact: first, only a fraction of these carcinomas develops through early stages of atypical hyperplasia, whereas the majority develops de novo.

Uterine and fetal findings at hysteroscopic evaluation of spontaneous abortions before D&C.

Study Objective: To evaluate the diagnostic benefit of fluid hysteroscopy before dilatation and curettage (D&C) in women with missed abortion, with respect to frequency of congenital and acquired uterine anomalies and geographic relationship of uterine anomalies to nidation site.

Design: Prospective case study (Canadian Task Force classification II-2).

Setting: Obstetric-gynecologic clinic of an academic teaching hospital.

The oestrogen receptor (ER) in normal and abnormal uterine tissue.

Glandular epithelium and stroma of the endometrium show typical behavioural patterns in the expression of oestrogen receptors (ERs) due to both endogenous and exogenous hormonal influence. Thus, the ER is increasingly expelled under the influence of oestrogen during the first half of the cycle. Under the influence of progesterone, the ER disappears during the luteal phase and is not even detectable after day 21.

[Room air as the etiology of gas embolism in diagnostic CO2 hysteroscopy].

During a diagnostic CO2-hysteroscopy in general anesthesia, a manifest gas embolism with a resulting drop of the endexpiratory CO2 partial pressure occurred upon insertion of the instrument. By ending the procedure and through appropriate anesthesiological measures, the occurrence was brought under control and the embolism had no clinical consequences. The incidence encouraged us to reconsider the CO2-hysteroscopy examination technique.

The etiology, frequency, and prevention of gas embolism during CO(2) hysteroscopy.

Study Objectives: To assess the frequency of clinically apparent and undetected cardiopulmonary emboli during diagnostic CO(2) hysteroscopy, to determine the causes of these events, and to define a risk profile.

Design: Retrospective and prospective case study (Canadian Task Force classification II-2).

Setting: Obstetric-gynecologic clinic of an academic teaching hospital.

Possibilities and limits of operative hysteroscopy: an update on transcervical resectoscopic uterine surgery.

In infertility therapy operative hysteroscopy by means of high-frequency surgery has replaced laparotomy in many cases. Thus today the therapy of intrauterine synechias, septa and myoma is a major sector in hysteroscopic metroplasty. Uterine haemorrhage is another area of indications for transcervical high-frequency surgery.

[The significance of laparoscopically-assisted vaginal hysterectomy--LAVH].

The truly minimal invasive surgeon should always act to the benefit of the patient. Since most of the operative steps of hysterectomy can be performed faster and often better via the vaginal approach than through trocars, minimal invasive surgery does not necessarily mean the employment of endoscopic techniques. Simple vaginal hysterectomy continues to be the least invasive method and 60% of all uteri can be removed this way.

[Tumor cell seeding caused by hysteroscopy?].

154 patients suffering from endometrial carcinoma who underwent CO2-hysteroscopy pretherapeutically, were examined as to whether hysteroscopy lead to tumour cell spread to the peritoneal cavity and worsened the prognosis of the patients. For that purpose, both fallopian tubes of 118 women were investigated thoroughly by histology for intratubarian spread of tumourous cells. Only in one of the 118 patients a single tumour cell complex was detected inside the ampullar part of a fallopian tube.

The Influence of Operative Laparoscopy on the General Operative Concept in Gynecology.

At Caritas-Klinik St. Theresia, Saarbrucken, Germany, 1663 patients underwent gynecologic surgery between 1990 and 1993. In the same period therapy via laparotomy was replaced stepwise by operative laparoscopy.

Use of an implantable catheter system for intraperitoneal chemotherapy in ovarian cancer.

To check the efficiency of intraperitoneal chemotherapy of ovarian carcinomas, 15 patients were treated with instillations of mitoxantrone or cisplatinum. An implantable catheter system was used to access the abdominal cavity. Local therapy proved to be without any effect when large tumor masses were treated.

[Value of vaginal ultrasonography in noninvasive assessment of the endometrium of the postmenopausal uterus].

The endometrial carcinoma shows an increasing incidence and represents today the most frequent malignoma of the female pelvis. Until now all techniques of detection of this carcinoma or its precursors are invasive and thus are not suitable for screening investigations. Vaginosonography, as the first non-invasive diagnostic method, now supplies knowledge about the state of the endometrium.

[Slit drainage versus Redon drainage in a clinical comparison--initial experiences with a new kind of wound drainage system].

In a prospective, randomised study we compared the clinical properties of the established Redon drain with a new type of drain called "slit drain". Both types of drains were examined regarding the amount of drained fluid, the time elapsing until removal of the drain, the frequency of occlusion of the lumen as well as the patient's pain and the required force at extraction of the drain. The statistical analysis showed both drains to have equal abilities in draining of fluid if they were used under vacuum conditions.