Impact of demographic and perioperative risk factors on complication rates in skin-sparing/nipple-sparing mastectomy with implant-based reconstruction using titanized polypropylene mesh (TiLOOP® Bra).

Background: Skin/nipple-sparing mastectomies (SSM/NSSM) have been reported to have acceptable complication rates and good aesthetic outcomes with high patient satisfaction. However, in this relatively young and rapidly expanding field of reconstructive plastic surgery, differences in perioperative management are noted between breast centers. Prospective studies of complication rates using a titanized polypropylene mesh (TiLOOP® Bra) are currently lacking.

Magnetic resonance imaging system for intraoperative margin assessment for DCIS and invasive breast cancer using the ClearSight™ system in breast-conserving surgery-Results from a postmarketing study.

Background And Objectives: Breast-conserving surgery (BCS) is followed by reoperations in approximately 25%. Reoperations lead to an increased risk of infection and wound healing problems as well as a worse cosmetic outcome. Several technical approaches for an intraoperative margin assessment to decrease the reoperation rate are under evaluation, some of them are still experimental.

Retromesenteric para-aortic lymphadenectomy in gynecologic malignancy.

Unlabelled: In gynecologic oncology lymphadenectomy is of prognostic and therapeutic importance because recurrence-free time and survival depend on the metastatic involvement of lymph nodes. Lymphadenectomies are not performed to such an extent as they are indicated. This might be due to a laborious or problematic preparation.

Unexpected malignancies after laparoscopic-assisted supracervical hysterectomies (LASH): an analysis of 1,584 LASH cases.

Objective: The objective of this research was to identify the rate of unexpected malignancies after laparoscopic-assisted supracervical hysterectomies (LASH) and describe the therapy regime.

Methods: The research is based on a retrospective chart analysis of patients undergoing a simple hysterectomy in the gynecological endoscopy department of a general hospital in Germany.

Results: 2,577 simple hysterectomies conducted between March 2005 and March 2010 were sub-classified in different types of hysterectomies (vaginal-, abdominal-, total-, abdominal supracervical hysterectomy, LAVH, and LASH).

Developing an interdisciplinary consultation service for vulvar disorders.

Background: Diseases of the vulva often cause severe impairment and long-term problems for the affected women. Adequate treatment requires expert knowledge on the part of treating dermatologists and gynecologists. This was the reason for the initiation of an interdisciplinary consultation service for vulvar diseases at the University Hospital of Lübeck.

Impact of cyclooxygenase-2 in breast cancer.

Prostaglandin metabolism plays a pivotal role in inflammatory processes and has also been demonstrated to have a role in carcinogenesis, tumor differentiation and tumor growth in breast cancer. Cyclooxygenase-2 (COX-2) is the key involved enzyme, as it triggers prostaglandin synthesis. We reviewed the current literature regarding the impact of prostaglandin metabolism on breast cancer and illustrated the current evidence of the COX-2 influence on breast cancer, delineating possible future prophylactic and therapeutic strategies.

Laparoscopic supracervical hysterectomy (LASH), a retrospective study of 1,584 cases regarding intra- and perioperative complications.

Objective: The main interest of this study was to assess the rate of intraoperative and perioperative complications of laparoscopic supracervical hysterectomy (LASH) in a teaching hospital.

Methods: A retrospective analysis of 1,584 laparoscopic assisted hysterectomies between 2005 and 2010 by different surgeons.

Results: In 2,577 patients undergoing simple hysterectomy, an indication for LASH was present in 1,584 cases.

Arthrogryposis multiplex congenita and Pena-Shokeir phenotype: challenge of prenatal diagnosis--report of 21 cases, antenatal findings and review.

Objective: To elaborate the antenatal sonographic findings of fetuses with the suspicion of fetal akinesia, thereby focusing on the accuracy of prenatal differentiation between subtypes of fetal akinesia, namely Pena-Shokeir phenotype (PSP) and arthrogryposis multiplex congenita (AMC).

Methods: We herein present our experience of 21 patients with PSP and AMC diagnosed antenatally at a tertiary prenatal referral center. During the study period 30,485 consecutive high- and low-risk pregnancies were examined.

Cancer in pregnancy. Part I: basic diagnostic and therapeutic principles and treatment of gynecological malignancies.

Purpose: Cancer in pregnancy is a rare circumstance. However, the coincidence of pregnancy and malignancy is supposed to increase due to a general tendency of postponing childbearing to older age. To date, clinical guidelines are scarce and experience regarding therapeutic management is limited to case reports.

Cancer in pregnancy. Part II: treatment options of breast and other non-gynecological malignancies.

Purpose: In case of non-gynecological solid tumors and hematological malignancies diagnosed during pregnancy, individual diagnostic and treatment options must be established by an interdisciplinary team.

Methods: In part II of the present review we report on diagnostic and therapeutic principles in distinct entities of solid and hematological malignancies.

Results: On the basis of a review of the current literature, clinical guidelines and algorithms have been established for diagnosis and therapy of maternal cancer during pregnancy.

Primary metastasized extraskeletal Ewing sarcoma of the vulva: report of a case and review of the literature.

Purpose: Ewing's sarcoma (ES) and primitive neuroectodermal tumor (PNET) are closely related malignant neoplasms, usually affecting the skeletal system. Extraosseous ES/PNETs are uncommon, with occasional reports of tumors affecting the genitourinary tract. Only few cases of primary vulvar Ewing's sarcoma/PNET have previously been reported.

Spontaneous uterine rupture at the 21st week of gestation caused by placenta percreta.

Purpose: To describe the management of a ruptured uterus caused by placenta percreta in the 21st week of gestation.

Methods: We present a case report of a 33-year-old patient with a ruptured uterus in the 21st week of gestation who presented at the Department of Gynecology and Obstetrics, University of Schleswig-Holstein, Campus Luebeck. Therapeutic management was performed by laparoscopy, and consecutive laparotomy and hysterectomy.

Laparoscopic management of ectopic pregnancy during a 9-year period.

The present study analyzed the epidemiology and outcome of ectopic pregnancy during a 9-year period on a total of 473 women. Our follow-up shows that laparoscopic salpingostomy, performed in 84.9% of the patients, is a safe and effective treatment for ectopic pregnancy.

Prostaglandin metabolising enzymes and PGE2 are inversely correlated with vitamin D receptor and 25(OH)2D3 in breast cancer.

Background: Breast cancer is associated with inflammatory processes based on an up-regulation of cyclooxygenase-2 (COX-2) expression. The antiproliferative effects of calcitriol (1,25(OH)(2)D(3)) mediated via the vitamin D receptor (VDR) render vitamin D a promising target in breast cancer therapy. First data suggest a correlation between vitamin D and prostaglandin metabolism.

Total laparoscopic hysterectomy without uterine manipulator: description of a new technique and its outcome.

Introduction: Hysterectomy remains the most common major gynecological operation. This is the first study that describes a new technique of TLH without using any kind of uterine manipulator or vaginal tube (TLHwM) and analyzes the intra- and postoperative surgical outcome of the first 67 cases.

Patients And Methods: Between October 2008 and December 2009, 67 patients underwent TLH without uterine manipulator or vaginal tube.

Expression of vitamin D receptor (VDR), cyclooxygenase-2 (COX-2) and 15-hydroxyprostaglandin dehydrogenase (15-PGDH) in benign and malignant ovarian tissue and 25-hydroxycholecalciferol (25(OH2)D3) and prostaglandin E2 (PGE2) serum level in ovarian cancer patients.

Ovarian carcinomas are associated with increased inflammation which is based upon an up-regulation of inducible cyclooxygenase-2 (COX-2). Moreover, based on our previous published data, the extra-renal vitamin D metabolism seems to be dysregulated in comparison to healthy tissue. In order to gain further insight into the prostaglandin (PG)- and vitamin D-metabolism in ovarian carcinomas, the study aimed to evaluate the expression of the PG metabolising enzymes COX-2 and 15-hydroxyprostaglandin dehydrogenase (15-PGDH) compared to the vitamin D receptor (VDR) in benign and malignant ovarian tissues.

Field evaluation of nitrogen availability from fresh and composted manure.

Prediction of manure nitrogen availability to crops is key to ensuring adequate production while minimizing potential adverse environmental impacts. This field study estimated first-year and residual N availability from several manures subjected to various levels of processing, and evaluated the applicability of the pre-sidedress soil N test (PSNT) in fields receiving the different manures using corn (Zea mays L.) as the test crop.

Estimates of residual dairy manure nitrogen availability using various techniques.

It is common practice to repeatedly apply dairy manure to the same fields. To accurately assess the total plant availability of manure nutrients, it is necessary to account for the nutrients remaining in soil from previous manure applications. A field experiment studying manure nitrogen (N) uptake by corn (Zea mays L.

Public health implications of meat production and consumption.

The high level of meat and saturated fat consumption in the USA and other high-income countries exceeds nutritional needs and contributes to high rates of chronic diseases such as cardiovascular disease, diabetes mellitus and some cancers. Affluent citizens in middle- and low-income countries are adopting similar high-meat diets and experiencing increased rates of these same chronic diseases. The industrial agricultural system, now the predominant form of agriculture in the USA and increasingly world-wide, has consequences for public health owing to its extensive use of fertilisers and pesticides, unsustainable use of resources and environmental pollution.

Comparison of estimates of first-year dairy manure nitrogen availability or recovery using nitrogen-15 and other techniques.

Measurements of dairy manure nutrient availability to crops typically show great variability. Approaches that are more accurate are needed to improve manure management and reduce nutrient loss to the environment. In this study, we compared direct (15N recovery) and indirect (difference method [Diff Meth] and fertilizer equivalence [FE] approach) methods of determining first-year dairy manure N availability or recovery during three cropping seasons.

Plant pathogen population dynamics in potato fields.

Modern technologies incorporating Geographic Information Systems (GIS), Global Positioning Systems (GPS), remote sensing, and geostatistics provide unique opportunities to advance ecological understanding of pests across a landscape. Increased knowledge of the population dynamics of plant pathogens will promote management strategies, such as site-specific management, and cultural practices minimizing the introduction and impact of plant pathogens. The population dynamics of Alternaria solani, Verticillium dahliae, and Pratylenchus penetrans were investigated in commercial potato fields.

Meeting the health needs of older homeless people.

Inclusion of health visiting services in packages of care for older people could play an important part in tackling the health and housing problems many experience, argues Kenneth Kelling. Here he draws attention to the often severe health problems of homeless older people and warns that current policies, far from improving their plight, will lead to further deterioration in services.