Torsten Schmidt

• University of Cologne

Intrauterine contraceptive device (IUCD) is a commonly used contraceptive method with the advantage of being a long-acting and reversible contraceptive method. However, its insertion can be rarely associated with serious complications such as uterine perforation, which can more rarely result in injury of the nearby viscus. In this report, we docume...

The uterine myometrium is the rarest location for an ectopic pregnancy resulting in the so-called ‘ intramural or intramyometrial ectopic pregnancy ’. It presents a particular diagnostic and therapeutic challenge for the treating physician. If passed undiagnosed can lead to life-threatening uterine rupture, which may warrant hysterectomy, leaving t...

Objectives: To characterize and describe treatment with Ulipristal acetate (UPA) in a pre-operative setting and to evaluate the safety, effectiveness, and Health Related Quality of Life (HRQoL) outcomes in a population treated according to standard clinical practice in the EU. Study design: Multi-centre, prospective, non-interventional study (PR...

Patient S. was born in 1983, developed a Ewing-Sarcoma and obtained low dose chemotherapy in 1996. In 2007, Patient S. received high-dose chemotherapy because lung-metastases were diagnosed. The aim of the study was to investigate the health of cryopreserved ovarian tissue and also to examine whether this ovarian tissue can restore the reproductive...

To achieve optimal and uniform outcomes, slow cooling protocols for human ovarian tissues generally initiate ice formation at high sub-zero temperatures (-6 to -9°C). The aim of the study was to investigate the function of ovarian tissue that had unintentionally self seeded at -20°C during the freezing step, by examining its development following c...

The aim of this study was to estimate the rate of intrauterine adhesions and subsequent pregnancy outcome in patients with residual trophoblastic tissue treated with hysteroscopic resection versus ultrasound-guided dilation and evacuation (D&E). Cohort study from 2 centers (Canadian Task Force classification II-2). Two surgical teams at the Univers...

The aim of this study was to estimate the benefit of excision of the endocervix during laparoscopic supracervical hysterectomy (LSH) with regard to postoperative cyclical bleeding. Cohort study from 2 centers (Canadian Task Force classification II-2). Two surgical teams at the University of Duesseldorf Medical Center and PAN Clinic, Cologne, German...

Purpose: Endometriosis is a common gynecological disease associated with pain and infertility. Endoscopic surgery with removal of endometriotic lesions is regarded as the best therapeutic option. However, in patients with deep infiltrating endometriosis and/or recurrent disease, effective non-operative treatment alternatives are lacking. Thus, a sp...

To evaluate a vascular endothelial growth factor (VEGF)-targeted gene therapy for the treatment of endometriosis. Analysis of the VEGF gene expression and promoter activity in ectopic and eutopic endometrium. Evaluation of the specific replication and cell-killing effect of a VEGF-targeted adenovirus (Ad5VEGFE1) in endometriotic cells. Four patient...

Unlabelled: Endometrial carcinoma is the most common genital cancer in women. While patients usually present with vaginal bleeding, in 10-20% this characteristic symptom is absent. Endometrial thickness (double layer) is measured by transvaginal sonography and thickening indicates an increased risk of malignancy or other pathology (hyperplasia or...

Gene therapy with adenoviral (Ad) vectors is a promising new approach in the treatment of cancer. Strategies to restrict adenoviral-mediated transgene expression are important to avoid gene transfer into normal cells. Heparanase (HPR) is overexpressed in breast cancer but downregulated in differentiated normal tissue. Expression of the HPR gene was...

Fragestellung: Der vorzeitige Blasensprung (VBS) scheint weder ein rein mechanisches noch ein generell infektioses Problem darzustellen. Verschiedene Extrazellularmatrix-(ECM-)modullierende Molekule wurden im Fruchtwasser beim vorzeitigen Blasensprung als in der Konzentration verandert beschrieben. Da die Identifikation des Bildungsorts, wie z.B. d...

Einleitung: Eine Krebsgentherapie auf der Basis rekombinanter Adenoviren vom Serotyp 5 (Ad5) ist ein neuartiger Ansatz in der Behandlung maligner Tumore. Die Vorraussetzung ist die gezielte Infektion der Tumorzelle bei gleichzeitiger Schonung des gesunden Gewebes. Ein Problem bei der Verwendung von Ad5 Vektoren ist der naturliche Lebertropismus die...

The question of whether Müllerian anomalies are significantly more often combined with endometriosis is a controversially discussed problem. Some publications described this association in patients with obstructive but not non-obstructive Müllerian anomalies or controls without Müllerian anomalies. The aim of this study was to evaluate the incidenc...

Die laparoskopische suprazervikale Hysterektomie (LASH) ist eine minimal-invasive Methode, die in den 1990er-Jahren zur Therapie der uterinen Blutungsstörung entwickelt wurde. Bislang existiert keine prospektiv randomisierte Studie zum Vergleich der LASH mit einer anderen Hysterektomieform. In einer prospektiv randomisierten Studie zum Vergleich de...

The endometrium carcinoma is the most frequent malignancy of the female genital tract. Approximately, 10-20% of all patients with an endometrial carcinoma are free of symptoms until the time of diagnosis. The frequent occurrence of an endometrial carcinoma in connection with intrauterine cavity fluid collection (sero- or mucometra) has been discuss...

Die Implantation bzw. ihr Ausbleiben werden multifaktoriell beeinflusst. Ein gesicherter anatomischer Einflussfaktor ist das Cavum uteri. Seit langem wird von einigen Autoren vor der Durchführung von Maßnahmen der assistierten Reproduktion eine Basishysteroskopie gefordert. In der Praxis hat sich dieses Konzept jedoch bisher nicht umfassend durchge...

This study was performed in order to investigate the role of the apoptotic index (AI) as a prediction parameter for the prognosis of patients with primary breast cancer. AI was determined by DNA fragmentation on 298 primary breast cancer samples and compared to clinically established breast cancer parameters. Additionally, we determined the express...

We report on a patient with metastatic breast cancer, who developed both a life-threatening grade 4 mucositis and a pancytopenia with neutropenic fever during a standard-dosed capecitabine therapy. This case shows the rare possibility of unusually severe 5-fluorouracil (5-FU) typical side effects associated with a normally well tolerated cytostatic...

To evaluate the importance of routine minihysteroscopy in the diagnosis of primary infertility. Retrospective study (Canadian Task Force classification II-2). Endoscopic center at a university hospital. Three hundred seventy-nine patients with primary infertility. Diagnostic minihysteroscopy without anesthesia or sedation. Hysteroscopy was normal i...

The long-term results for patients with recurrent ovarian cancer (ROC) are poor. There is a need to optimize treatment strategies to improve outcome by avoiding ineffective regimens which are often associated with exacerbated side-effects. Individualized chemotherapy regimens guided by a chemosensitivity assay (ATP-tumor chemosensitivity assay) hav...

Successful implantation occurred after embryo transfer in the presence of an extensive endometrial defect after hysteroscopic resection of residual trophoblastic tissue 15 months after cesarean section. At the end of hysteroscopic surgery the anterior uterine wall seemed smooth, although ultimately no endometrium was left in that part and in parts...

The aim of this study was to determine the dose-limiting toxicities (DLTs) and maximum tolerated doses (MTDs) of a docetaxel-carboplatin regimen in patients with locally advanced cervical cancer (LACC) or recurrent cervical cancer. The regimen was administered weekly, with a maximum of 12 courses. Twenty patients were treated with with a total of 1...

The aim of the retrospective study was to evaluate the "optimal" postoperative management after hysteroscopic metroplasty. METHODS. FIFTY-TWO: infertile patients with a septate uterus were included. Hysteroscopic metroplasty was performed using electrocautery (dissection needle) with postoperative cyclical hormone replacement therapy (HRT) + intrau...

The transvaginal sonography is a non invasive diagnostic method to evaluate the endometrium. It has a high reliability in the diagnosis of endometrial carcinoma, in the assessment of the depth of myometrial invasion as well as in preoperative staging. Patients with an episode of postmenopausal vaginal bleeding and an endometrial thickness (double l...

Ectopic pregnancies sited in dehiscent cesarean section scars have a high risk of rupture and bleeding. Attempts at operative therapy frequently end in loss of the uterus. A connection with the cavum uteri justifies an attempt at dilatation and curettage. We describes a patient with combined systemic and local intra-amniotic methotrexate (MTX). The...

The following retrospective study is intended as a contribution towards determining the necessity of a hysteroscopic metroplasty in patients with primary infertility. - 21 patients with primary infertility and a septate uterus, who had undergone a hysteroscopic dissection of the septum between 1993 and 2000, were evaluated. With the help of medical...

A 37-year-old patient had recurring thromboses, occlusion of the left femoral vein with hereditary hyperhomocysteinemia, hypermenorrhea and anaemia. Conservative therapy with endometrium ablation and gestagene failed. A supracervical hysterectomy was done to preserve the presacral and left lateral, dorsal and caudal collaterals beside the uterus, a...

Bilateral ovarian fibromas are a rare condition. We report a case of bilateral ovarian fibromas with endometrial adenocarcinoma in a postmenopausal woman who clinically showed symptoms of an estrogen-producing tumour. Clinical and histopathological problems in the pre- and intraoperative diagnostics of fibromas are discussed.

To assess the diagnostic value of maternal CA 125 in patients with symptomatic first trimester pregnancy and to evaluate the prognostic significance of CA 125 versus beta-hCG in early pregnancies with intact fetal heartbeat, complicated by vaginal bleeding. Two prospective open-label studies with longitudinal follow-up in the second trial. Academic...

Fragestellung Das Endometrium-Ca stellt das häufigste Malignom des weiblichen Genitale dar. Ungefähr 10 - 20 % aller Patientinnen mit einem Endometriumkarzinom sind bis zur Diagnosestellung symptomfrei. Ein gehäuftes Auftreten eines Endometriumkarzinoms im Zusammenhang mit einer intrauterinen Flüssigkeitsansammlung (Sero- oder Mukometra) wird in de...

In the work presented here, obstetric management after a previous caesarean section was studied in a large patient group at the University Department of Gynecology and Obstetrics in Cologne from 1979 to 1995. Particular attention was given to the feared complication of uterine rupture. From a total of 15 166 deliveries, 1086 of the births had been...

In the presented paper, obstetrical management after previous caesarian section was studied in a large patient collective at the University Department of Gynaecology and Obstetrics in Cologne from 1979 to 1995. Particular attention was given to the feared complication of rupture of the uterus. From a total of 15,166 deliveries, 1,086 of the births...

Transvaginal hydrolaparoscopy (THL) was evaluated in comparison with the already established chromolaparoscopy in the detection of tubal factors, adhesions as well as endometriosis. 43 infertile patients without previous pelvic operations and with an inconspicuous clinical examination were included in a prospective comparative study of THL and chro...

Our report concerns a patient with a climacterium praecox and an X-chromosomal anomaly (86% 46, XX; 7% 47, XXX; 7% 45, X0) desiring to give birth. She conceived once after down-regulation of the gonadotrophins by means of a cyclical hormone replacement therapy followed by gonadotrophin stimulation, as well as a second time under down-regulation wit...

Fragestellung: In der vorliegenden Arbeit wird das geburtshilfliche Management bei Zustand nach Sectio anhand eines großen Patientinnenkollektivs der Universitätsfrauenklinik Köln in den Jahren 1979-1995 untersucht. Besonderes Augenmerk gilt der gefürchteten Komplikation der Uterusruptur. Material und Methode: Aus einem Gesamtkollektiv von 15 166 E...

Leptin wird bevorzugt von den Adipozyten synthetisiert und könnte das Bindeglied zwischen Fettgewebe und Gehirn darstellen. In bezug auf die Reproduktion könnte die Leptinresistenz insbesondere in der Pathogenese des PCO-Syndroms eine Rolle spielen. Derzeit existieren dazu aber widersprüchliche Daten, so daß weiterer Klärungsbedarf besteht. Leptin...

Fragestellung: Die vorliegende Arbeit untersucht an 20 Patientinnen mit situativ induzierter Angst die anxiolytische Wirkung des pflanzlichen Präparates Kavosporal forte. Material und Methoden: Die Angstproblematik war eine akute, beruhend darauf, daß die Patientinnen auf das Ergebnis einer histopathologischen Diagnose bei suspekten Brustdrüsenbefu...

Small suspicious breast lesions that are only visible at MR imaging were preoperatively marked with a hook wire under MR-guidance to allow the removal of the lesion with tissue-sparing surgery. In all patients the suspicious lesions were marked preoperatively under MR guidance with a hook wire using a commercially available stereotactic device. Int...

Wir beschreiben 2 Patientinnen mit einer Narbenendometriose unterschiedlicher Symptomatik nach Sectio caesarea. Anhand der Kasuistiken sowie der Literatur werden die differenzialdiagnostischen Probleme, Therapie und Komplikationen diskutiert. Summary We describe two patients with symptomatic scar endometriosis following cesarean section. We discuss...

We report on a 72-year-old patient developing Stewart-Treves syndrome (STS) of the right arm 9 years after curative irradiation for ipsilateral stage III breast cancer. Facing the poor track record of both irradiation and chemotherapy in this highly malignant lymphangiosarcoma, amputation was recommended but refused by the patient. Therefore, limb...

Hysteroscopic surgery is widely used for the treatment of patients suffering from infertility and menorrhagia. Preoperative and postoperative treatment plays an important role in this kind of surgery. The indications for hormonal pre- and postoperative treatment are very different and depend on the type of surgery and the condition of the patient....

Leptin is mainly synthesized by adipocytes and might represent the connecting link between fatty tissue and brain. In reference to reproduction, leptin resistance could play a role particularly in the pathogenesis of the PCO syndrome. However, there exists at present contradictory data on this, so that further clarification is necessary. Leptin int...

The present study examined the anxiolytic effect of the herbal preparation Kavosporal forte in 20 patients with situationally induced anxiety. The degree of anxiety was acute in that the patients were waiting for the results of a histopathological diagnosis, carried out on account of suspect mammary findings, and therefore feared they were sufferin...

Das Endometriumkarzinom stellt zur Zeit das häufigste Malignom des weiblichen Genitale dar. Ungefähr 10 - 20 % aller Patientinnen mit einem Endometriumkarzinom sind bis zur Diagnosestellung symptomfrei. In der Literatur findet man verschiedene Angaben, ab welcher Endometriumdicke man mit intrakavitären Pathologien in der Postmenopause rechnen muß (...

Fragestellung: Die vor einigen Jahren am Misgav-Ladach General Hospital in Jerusalem entwickelte Operationstechnik der Sectio caesarea unterscheidet sich von der konventionellen Technik im wesentlichen durch stumpfe Eröffnung des Bauchraumes, Uterotomie oberhalb der Blasenumscnlaqsfalte und den Verzicht auf einen Verschluß des parietalen Peritoneum...

Purpose: Postoperative recovery following Caesarean section reduces the mother's ability to care for her newborn. Efforts to lessen postoperative disability facilitate the mother's competence and decrease costs. A new operative technique for Caesarean section was suggested at Misgav-Ladach (ML) Hospital in Jerusalem. By favouring a less disruptive...

63 cases of adenomatous endometrial hyperplasia (1st-3rd degree) were diagnosed by hysteroscopy and D&C at the Department of Obstetrics and Gynaecology of the University of Greifswald from January 1991 to December 1994. In 40 patients with adenomatous hyperplasia (2nd-3rd degree) a hysterectomy was performed. 23 patients presenting with 1st degree...

The seasonal incidence of 472 ectopic pregnancies in the years 1984-1993 in the Departments Obstetrics and Gynaecology Greifswald and Neubrandenburg were analysed. While the birth rate was decreasing in the third and fourth quarter of the year there was a low, no significant increase of ectopic pregnancies from 1.30% (April-June) to 1.75% (October-...