E Dreher

Inselspital, Universitätsspital Bern, Berna, Bern, Switzerland

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Publications (52)125.44 Total impact

  • N. A. Bersinger · E. Dreher · M. D. Mueller
    Fertility and Sterility 09/2005; 84. DOI:10.1016/j.fertnstert.2005.07.481 · 4.59 Impact Factor
  • A Kuhn · E Dreher
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    ABSTRACT: Emergency consultations happen frequently in gynaecology and may be due to abdominal pain, itching, utero-vaginal bleeding, rape, emergency contraception, insertion of foreign bodies, prolapse and urinary tract infection. Considering pregnancy in patients with child bearing potential is essential. Vaginal bleeding may be due to atrophy, infection, carcinoma or pregnancy. In the latter it is crucial to differentiate between ectopic, pathologic or physiologic pregnancy. In postmenopausal women further investigations by the gynaecologist are mandatory to exclude malignancy. Patients who have been raped need psychological, forensic and gynaecological support. Sexually transmitted disease including HIV must be considered and prophylactic drugs should be administered. If unprotected intercourse has occurred the "morning after pill" can be considered within 72 hours after intercourse or an IUD up to five days. Prolapse occurs rarely as an acute problem but may induce urinary retention. Urinary tract infection is a common complaint and should be treated with antibiotics.
    Therapeutische Umschau 07/2005; 62(6):359-62.
  • A. Kuhn · E. Dreher
    Therapeutische Umschau 06/2005; 62(06):0359-0362. DOI:10.1024/0040-5930.62.6.359
  • K. C. Nessensohn · E. Dreher · A. Kuhn
    Geburtshilfe und Frauenheilkunde 09/2004; 64(9):912-916. DOI:10.1055/s-2004-820930 · 0.94 Impact Factor
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    Ultrasound in Obstetrics and Gynecology 08/2004; 24(3):232 - 232. DOI:10.1002/uog.1178 · 3.85 Impact Factor
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    ABSTRACT: We report two women who presented with a recurrent, mildly painful, bluish nodule in the umbilicus. Both patients complained of local tenderness and occasional bleeding that increased during menstruation. Neither patient had had previous pelvic surgery. Excision of the lesions revealed a primary umbilical endometriosis; in one case, a simultaneous laparoscopy showed a pelvic endometriosis. We review the current literature and discuss the possible etiopathogenesis and when a laparoscopy is indicated to diagnose a concomitant pelvic endometriosis. Umbilical endometriosis is a very rare disease but should be considered in the differential diagnosis of umbilical lesions.
    Surgical Endoscopy 03/2004; 18(2):347. DOI:10.1007/s00464-003-4245-6 · 3.26 Impact Factor
  • A Kuhn · F Anthony · A Monga · E Dreher · I Cameron
    Geburtshilfe und Frauenheilkunde 12/2003; 63(12). DOI:10.1055/s-2003-815268 · 0.94 Impact Factor
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    ABSTRACT: Members of the Eph family of tyrosine kinases have been implicated in embryonic pattern formation and vascular development; however, little is known about their role in the adult organism. We have observed estrogen-dependent EphB4 expression in the normal breast suggesting its implication in the hormone-controlled homeostasis of this organ. Since the endometrium is a similarly hormone dependent organ and endometrial carcinoma is thought to result from estrogenic stimulation, we have investigated EphB4 expression in normal human endometrium and during its carcinogenesis. EphB4 expression was analyzed immunohistochemically in 26 normal endometrium specimens, 15 hyperplasias and 102 endometrioid adenocarcinomas and correlated with clinical and prognostic tumor characteristics. In normal endometrial tissue no EphB4 protein was detected. Strikingly, we observed a drastic increase (P <0.0001) in the number of EphB4 protein-expressing glandular epithelial cells in the majority of hyperplasias and carcinomas. Moreover, we found a statistically highly significant positive correlation between EphB4 expression and post-menopausal stage of the patient (P = 0.007). These findings indicate that in the endometrium, EphB4 is an early indicator of malignant development and, thus, EphB4 may represent a potent tool for diagnosis and therapeutic intervention.
    Annals of Oncology 02/2003; 14(2):220-6. DOI:10.1093/annonc/mdg072 · 7.04 Impact Factor
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    Ultrasound in Obstetrics and Gynecology 01/2003; 22(S1):173 - 173. DOI:10.1002/uog.851 · 3.85 Impact Factor
  • I. Dingeldein · T. Eggimann · E. Dreher · A. Kuhn
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    ABSTRACT: Purpose: We evaluated the medium-term results obtained with the Tension-free Vaginal Tape operation. Methods: Over a 3-year period a total of 122 patients underwent a Tension-free Vaginal Tape operation for treatment of genuine stress incontinence. All patients were studied prospectively and underwent urodynamic studies before and after surgery. Postoperatively patients underwent urodynamic testing and subjective assessment at 6-12 and at 12-24 months. Results: The subjective and objective cure rates were 70% and 61%, respectively. Perioperative complications included bleeding, bladder perforation, voiding problems and de novo urgency. Preoperative urgency seemed to improve postoperatively. Conclusion: Overall there were few complications and the procedure was successful despite a mixed level of surgical experience.
    Geburtshilfe und Frauenheilkunde 11/2002; 62(11):1081-1087. DOI:10.1055/s-2002-35976 · 0.94 Impact Factor
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    ABSTRACT: STAT proteins constitute a family of transcription factors whose activation by cytokine and non-cytokine receptors leads to tyrosine phosphorylation, dimerization and translocation from the cytoplasm to the nucleus. In the nucleus they activate the transcription of specific genes by binding to consensus DNA elements. STATs 1 and 3 can be activated by both cytokine and non-cytokine receptors, and bind as homodimers or heterodimers to viral simian sarcoma virus (sis)-inducible elements such as that found in the c-fos promoter. Activation of c-Src and EGF receptor tyrosine kinases is associated with progression of breast cancer. Both these events lead to activation of STAT proteins, Src kinases activate STAT3 dependent transcription in mammary epithelial cells and EGF receptor activation can lead to activation of STATs 1 and 3. STAT3 activation has been demonstrated to have a role in oncogenesis and increasingly, activated STAT proteins are found to be activated in human cancer. In this study we describe detailed immunohistochemical analysis of nuclear and cytoplasmic STATs 1 and 3 expression in primary breast carcinomas and correlate this with EGFR, HER2, p53, ER, PR, p21/waf1, Bcl-XL and Ki-67 expression. We also compared expression between normal and tumor tissue. We report here a highly significant correlation between nuclear STAT3 expression and breast cancers compared to normal tissue. We also report a very strong correlation between nuclear STAT3 and EGFR expression in breast cancers. These data clearly demonstrate a strong association between STAT3 activation and breast tumorigenesis and strengthen the assertion that STAT3 activation may play an important role in the tumorigenic conversion of breast tissue mediated by tyrosine kinase signaling pathways.
    International Journal of Oncology 01/2002; 19(6):1155-60. DOI:10.3892/ijo.19.6.1155 · 3.03 Impact Factor
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    ABSTRACT: Axl, a member of a family of receptor tyrosine kinases characterized by an extracellular domain resembling cell adhesion molecules and an intracellular conserved tyrosine kinase domain has been reported to induce cell proliferation and transformation. In mice, axl is expressed in the normal mammary gland and over-expressed in aggressive mammary tumors. We have investigated the expression of axl immunohistochemically in 23 normal human breast samples and in 111 consecutive breast carcinomas. Expression of axl was correlated with tumour characteristics (lymph node involvement, stage, grade) and immunohistochemical expression of ER, PR, Ki-67 and c-erbB-2. In normal tissue, axl localizes to the membrane of breast epithelial cells. Axl protein shows membrane associated staining in high correlation (P = 0.004) with the expression of the estrogen receptor (ER). Axl expression was found in a subset of breast carcinomas and was also correlated with high significance (P < 0.0001) with the presence of ER. Our results suggest that axl may serve as a mediator of estrogen stimulation preventing the completion of the breast epithelial life cycle and that estrogen induced axl expression may give a survival signal to cancerous cells, preventing them from dying through apoptosis.
    Annals of Oncology 07/2001; 12(6):819-24. DOI:10.1023/A:1011126330233 · 7.04 Impact Factor
  • S Spörri · H J Altermatt · E Dreher · W Hänggi
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    ABSTRACT: Cervical adenocarcinoma and genitourinary malformations are relatively common disorders, yet their coexistence is rare. A 49-year-old woman developed clear cell adenocarcinoma in the atretic hemicervix of a communicating uterus type 7 and had ipsilateral renal agenesis. Compared with the unaffected right hemicervix, only the tumor-involved glands of the atretic left hemicervix contained ciliated tuboendometrial cells. Four and a half years after radical hysterectomy and pelvic radiation, she showed no evidence of recurrence. In contrast to current opinion, communicating uteri type 7 are associated with ipsilateral renal agenesis. Our histologic findings support the hypothesis that tuboendometrial cells are the cells of origin for cervical clear-cell adenocarcinoma.
    Obstetrics and Gynecology 12/2000; 96(5 Pt 2):834-6. DOI:10.1016/S0029-7844(00)01050-4 · 5.18 Impact Factor
  • M. D. Mueller · E. Dreher · R. N. Taylor
    Geburtshilfe und Frauenheilkunde 12/2000; 60(12):585-593. DOI:10.1055/s-2000-9542 · 0.94 Impact Factor
  • S Balli · M F Fey · W Hänggi · D Zwahlen · G Berclaz · E Dreher · S Aebi
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    ABSTRACT: The purpose of this study was to investigate the prognostic importance of the health insurance status in 145 consecutive patients with ovarian cancer diagnosed between 1984 and 1996. All patients had basic (Type III) insurance to cover outpatient treatment and hospital expenses for a per diem flat fee; some patients had one of two types of supplemental private insurance (Type I and Type II) to cover the treatment by physicians of their choice and fee-for-service hospital treatment. The prognostic impact of health insurance was evaluated by multivariate statistical methods. The median follow-up was 81.9 months (range: 21-181); the 5-year probability of survival was 72% (standard error of the mean (SEM) 9.8%) for stage I, 53% (SEM 16.2%) for stage II, 17% (SEM 5. 9%) for stage III and 11% (SEM 5.5%) for stage IV cancer. Age, stage, histological grade and debulking surgery were independent predictors of survival in multivariate proportional hazards regression analysis. Patients with private insurance were younger and received more chemotherapy than patients with basic insurance. In multivariate analysis, insurance was an independent predictor of survival: patients with Type II insurance had a hazard ratio of 2.31 (95% confidence interval (CI): 1.05-5.04), and patients with Type III insurance had a hazard ratio of 3.30 (95% CI 1.52-7.17) compared with the reference group of Type I insured patients. Health insurance status was an independent predictor of survival in ovarian cancer. Research is needed to devise strategies to improve the medical care of patients with basic insurance.
    European Journal of Cancer 11/2000; 36(16):2061-8. DOI:10.1016/S0959-8049(00)00193-3 · 5.42 Impact Factor
  • Gynäkologisch-geburtshilfliche Rundschau 09/2000; 40(2):71-79. DOI:10.1159/000022335
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    ABSTRACT: iyk, a member of the frk family of non-receptor tyrosine kinases, was originally isolated from normal mouse mammary glands and is characterized by a nuclear localizing signal within the SH2 domain. We have investigated the expression and subcellular localization of iyk in the normal human breast and in malignant breast diseases. Immuno-histochemical analyses revealed that in normal tissue iyk localizes to both cytoplasmic and nuclear compartments of breast epithelial cells. The subcellular distribution was dependent on the hormonal state, being mostly cytoplasmic during the follicular, proliferative phase of the menstrual cycle, whereas frequent nuclear staining was observed in the resting stages during the luteal phase and, most prominently, after menopause. Strikingly, invasive carcinomas, irrespective of tumor type or hormonal status of the patient, exhibited almost complete loss of iyk expression in both the cytoplasm and the nucleus. In contrast, in situ breast carcinomas from post-menopausal patients showed a clear reduction of the nuclear iyk localization while retaining cytoplasmic staining. Our results indicate that iyk expression is gradually lost during carcinogenesis; thus, iyk may be classified as a tumor-suppressor gene.
    International Journal of Cancer 04/2000; 85(6):889-94. · 5.09 Impact Factor
  • L Bronz · E Dreher · A Almendral · A Studer · U Haller
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    ABSTRACT: 2.1. History and clinical-gynecological investigation including a Pap smear are the first step in the clarification. The history should make sure if there is in fact bleeding from the genital and not from the urological or the intestinal region. Drug intake should be recorded, and risk factors for the development of endometrial carcinoma should be considered. This will not affect further investigation. The clinical-gynecological investigation should prove the source of postmenopausal bleeding according to the anatomical site--uterine, infra-, or suprauterine. The causes of infrauterine bleeding may easily be diagnosed by means of inspection of the external genitalia and further by using a speculum. The causes of uterine bleeding are of major importance. Cytology and colposcopy, supported by bimanual investigation, exclude cervical carcinoma as a cause of bleeding. Atypical endometrial cells on the cytological smear arouse suspicion of endometrial carcinoma. 2.2. Transvaginal sonography (TVS) is the next step if the above-mentioned investigations are negative. Both adnexa should always be investigated and the findings sonographically documented, so that solid cystic masses in the adnexal area can be better identified as suprauterine causes of postmenopausal bleeding. Then the uterus should be investigated. Further procedures are decided from the results of measurement of the longitudinal section of the endometrium at the level of maximum endometrial thickness. If the endometrial thickness is _<4 mm, an observant attitude can be assumed. After 3 months the patient should be controlled against using TVS. If bleeding recurs or the endometrial thickness is >4 mm on TVS, the procedure given in subparagraph 2.3 should be followed. In case the endometrial thickness is >4mm or not measurable, a histomorphological investigation according to subparagraph 2.3 should be performed. In such cases, saline infusion sonohysterography(SIS) is useful as a simple method to supplement TVS. It can aid in the decision making as to which further, more invasive measures should be taken (endometrial biopsy/hysteroscopic resection). Computerized tomography or magnetic resonance imaging are, as a rule, not indicated in patients with postmenopausal bleeding. 2.3. A definite diagnosis is possible only on the basis of a histological investigation. If TVS or SS show evidence of a polypoid state, removal under hysteroscopic control is the diagnostic method of choice. In cases of symmetrical or asymmetrical thickening of the endometrium on SIS, a less invasive biopsy may be sufficient. If the biopsy specimen does not yield representative diagnostic material, one should proceed as described above. A fractionated curettage should as a rule not be performed solely, but in combination with hysteroscopy.
    Gynäkologisch-geburtshilfliche Rundschau 01/2000; 40(2):71-9.
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    ABSTRACT: The objectives of this retrospective study were to analyze the morbidity of surgical staging and to evaluate the omission of external radiotherapy in high-risk patients with stage I and II endometrial carcinoma when the lymph nodes were negative. From 1988 to 1996, 63 of 117 patients underwent a pelvic and periaortic lymphadenectomy. The decision to perform lymphadenectomy was influenced by patient general health. Patients with lymphadenectomy had a better physical status (P < 0.0001). Lymphadenectomy increased mean operative time (P < 0.0001) and blood loss (P < 0.01), but there was no increase in postoperative complications. At a median follow-up of 54 months, there was one cuff recurrence in 56 patients. Nineteen high-risk patients without external pelvic radiation had the same disease-free survival rate as 37 low-risk patients (P = 0.1). In the group without lymphadenectomy, the disease-free survival for 18 high-risk patients and 32 low-risk patients was similar (P = 0.21). Surgical staging in properly selected patients does not increase postoperative complications and brachytherapy without external radiotherapy is associated with excellent disease-free survival when the lymph nodes are negative.
    International Journal of Gynecological Cancer 08/1999; 9(4):322-328. DOI:10.1046/j.1525-1438.1999.99043.x · 1.95 Impact Factor
  • M D Mueller · C Camartin · E Dreher · W Hänggi
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    ABSTRACT: This study was designed to compare conventional laparoscopy with three-dimensional (3-D) laparoscopy. Thirty candidates, 20 inexperienced and 10 experienced in operative laparoscopy, executed standardized exercises on a pelvitrainer. The candidates were randomized to two groups. Group A executed the exercises first with the conventional and then with the three-dimensional system. Group B accomplished the exercises in the reverse sequence. At the end of the exercises, the candidates answered specific questions about the two systems. A total of 21 h 6 min 6 sec of laparoscopic exercises were analyzed-10 h 8 min 1 sec with the conventional and 10 h 58 min 5 sec with the three-dimensional system (p = 0.38). Group A required 12 h 26 min 56 sec to perform all the exercises. There was no statistically significant difference from group B, where the candidates needed 8 h 39 min 10 sec (p = 0.14). Neither were there any differences in the number of failed attempts between the two groups. There were also no statistical difference when the results obtained from the candidates without experience in laparoscopy and the participants experienced in operative laparoscopy were analyzed separately. Both the inexperienced and the experienced candidates became tired earlier, had more headaches, and needed extra time to adapt to the 3-D system. When analyzed in a standardized fashion, 3-D laparoscopy does not have any significant advantages over conventional laparoscopy.
    Surgical Endoscopy 06/1999; 13(5):469-72. DOI:10.1007/s004649901014 · 3.26 Impact Factor

Publication Stats

348 Citations
125.44 Total Impact Points


  • 1993–2005
    • Inselspital, Universitätsspital Bern
      • Department of Obstetrics and Gynaecology
      Berna, Bern, Switzerland
  • 1992–2004
    • Universität Bern
      • Department of Clinical Research
      Berna, Bern, Switzerland