G Emons

Universitätsmedizin Göttingen, Göttingen, Lower Saxony, Germany

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Publications (411)786.32 Total impact

  • No preview · Article · Feb 2016 · Geburtshilfe und Frauenheilkunde
  • Nina Bock · Günter Emons
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    ABSTRACT: Hintergrund: Akzidentelle und nicht akzidentelle Traumata außerhalb des peripartalen Zeitraumes treten häufig auf und stellen eine besondere Herausforderung in der Versorgung dar. Fragestellung: Die vorliegende Arbeit möchte einen Überblick über die einzelnen Verletzungsmuster bieten und die Fragen beantworten, was die Anamnese berück-sichtigen sollte, welche einzelnen diagnostischen Schritte und Therapien einzuleiten sowie welche Differentialdiagnosen zu erwägen sind. Material und Methode: Narrativer Review der Literatur mittels Recherche in der Da-tenbank Pubmed via Medline mit den Suchbegriffen genital/ vulvovaginal/ genitourinary injuries/ injury, nonobstetric lacerations und sexual assault/ abuse. Ergänzt wurden diese Ergebnisse durch Handsuchen in den Literaturverzeichnissen der Suchergebnisse und der Sekundärliteratur. Ergebnisse: Durch stumpfes Trauma, rasche Grätschung der unteren Extremität, akzidentelle Perforation und Pfählung, sexuellen Missbrauch und Kohabitationsverletzungen sowie Intimrasur entstehen Genitalverletzungen. Obwohl es sich um lebensbedrohliche Verletzungen handeln kann, ist die zeitliche Inanspruchnahme von Hilfe aus Schamgefühl teilweise verzögert. Schlussfolgerungen: Die Kenntnis des Verletzungsmechanismus unterstützt bei der korrekten Untersuchung sowie Einleitung weiterer diagnostischer und therapeutischer Schritte. Diese reichen von konservativen Maßnahmen bis hin zur Explorativlaparotomie.
    No preview · Article · Jan 2016 · Der Gynäkologe
  • Günter Emons

    No preview · Article · Dec 2015 · Der Gynäkologe
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    ABSTRACT: Objectives: To evaluate activity and toxicity of mTOR inhibitor temsirolimus in patients with platinum-refractory/resistant ovarian cancer (OC) or advanced/recurrent endometrial carcinoma (EC). Methods: Women with epithelial ovarian, fallopian tube or primary peritoneal cancer were eligible, when they had progression during treatment with a platinum based regimen or within 6 months after receiving a platinum based regimen and a previous taxane treatment. Women with advanced/recurrent EC, no longer amenable to curative surgery and/or radiotherapy were eligible when they had no previous or only adjuvant chemotherapy. Preceding endocrine therapy for metastatic/recurrent disease was allowed. Patients received weekly IV infusions of 25 mg temsirolimus. Primary endpoint was progression free survival rate after 4 months (OC) or 6 months (EC). A two stage design was applied. Results: Forty-four patients (OC: n = 22; EC: n = 22) were enrolled and received temsirolimus treatment. Median age was 56 years (OC) or 63 years (EC). After eight weeks of treatment, 10 of 21 evaluable patients in the OC cohort and 8 of 20 evaluable patients in the EC cohort had progressive disease. Thus efficacy did not meet the predefined levels during the first stage of recruitment and the trial was stopped. Some patients in both cohorts had long lasting PFS (> 7 months). Toxicity of temsirolimus was mild. Conclusions: Temsirolimus treatment was well tolerated in our patients, but did not meet the predefined efficacy criteria. In our study as in other trials on rapalogs in OC or EC, a few patients had long lasting disease stabilisations.
    No preview · Article · Dec 2015 · Gynecologic Oncology
  • G. Emons
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    ABSTRACT: Background: Hormonal contraceptives (oral contraceptives, OC) are the most frequently prescribed drugs for women of reproductive age. Even small modifications in cancer risks induced by OC would lead to relevant changes in cancer incidences. Methods: Narrative review of the literature (PubMed including 2014) using the search terms hormonal contraception and cancer. Results: The use of OC markedly reduces the risk of ovarian and endometrial cancer. The risk of breast cancer is temporarily slightly increased especially if OC use starts before the age of 20 or before the first pregnancy. Comparable effects were observed in women with BRCA mutations. The results concerning OC-induced risk modifications for cervical and colorectal cancer are unclear. Use of OCs does not lead to an overall increased risk of cancer.
    No preview · Article · Sep 2015
  • G. Emons
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    ABSTRACT: Endometrial hyperplasia with atypia harbours a high potential for progression to invasive endometrial cancer (EC). In many cases it is already associated with invasive EC. The adequate therapy for endometrial hyperplasia with atypia as well as for well differentiated endometrioid EC limited to the endometrium is total hysterectomy, resulting in a cure rate of virtually 100%. If preservation of fertility is desired, a conservative management using high dose oral progestagens can be considered, if certain prerequisites are met. In case of atypical endometrial hyperplasia complete remissions can be achieved in 66% to 86%. After initial response, however, 20% to 26% of patients have a relapse. 26% to 41% of conservatively treated patients with atypical endometrial hyperplasia become pregnant. Patients with low grade (G1) endometrioid EC, limited to the endometrium, have a remission on conservative treatment in 48% to 81%. After initial response, there is a relapse rate of 20% to 40%. Pregnancies are achieved in about 30%. In 2% to 15% progressive disease occurred on conservative treatment. Fatal courses have been described. When child bearing capacity is no longer desired, a total hysterectomy should be performed.
    No preview · Article · Aug 2015
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    ABSTRACT: The European Society of Breast Cancer Specialists (EUSOMA) has fostered a voluntary certification process for breast units to establish minimum standards and ensure specialist multidisciplinary care. In the present study we assess the impact of EUSOMA certification for all breast units for which sufficient information was available before and after certification. For 22 EUSOMA certified breast units data of 30,444 patients could be extracted from the EUSOMA database on the evolution of QI's before and after certification. On the average of all units, the minimum standard of care was achieved for 12/13 QI's before and after EUSOMA certification (not met for DCIS receiving just one operation). There was a significant improvement of 5 QI's after certification. The proportion of patients with invasive cancer undergoing an axillary clearance containing >9 lymph nodes (91.5% vs 89.4%, p 0.003) and patients with invasive cancer having just 1 operation (83.1% vs 80.4%, p < 0.001) dropped, but remained above the minimum standard. The targeted standard of breast care was reached for the same 4/13 QI's before and after EUSOMA certification. Although the absolute effect of EUSOMA certification was modest it further increases standards of care and should be regarded as part of a process aiming for excellence. Dedicated units already provide a high level of care before certification, but continuous monitoring and audit remains of paramount importance as complete adherence to guidelines is difficult to achieve. Copyright © 2015 Elsevier Ltd. All rights reserved.
    No preview · Article · Jun 2015 · European journal of surgical oncology: the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
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    ABSTRACT: Recently we have shown that breast cancer cell invasion was dramatically increased when co-cultured with MG63 cells. In addition we have generated mesenchymal transformed MCF-7 breast cancer cells (MCF-7-EMT), showing significantly increased invasion in contrast to wild type MCF-7 cells (MCF-7 WT). In this study we have analyzed whether stromal derived factor-1 (SDF-1) is responsible for MCF-7 and T-47-D breast cancer cell invasion and epithelial-mesenchymal-transition (EMT). In addition we have analyzed whether kisspeptin-10 (KP-10) treatment affects SDF-1-induced invasion and EMT. Invasion was quantified by assessment of MCF-7 and T-47-D breast cancer cell migration rate through an artificial basement membrane in a modified Boyden chamber during co-culture with MG63 cells or after treatment with SDF-1α, SDF-1β or the combination of both isoforms. Induction of EMT was verified by analysis of protein expression of epithelial marker E-cadherin (CDH1) and mesenchymal markers N-cadherin (CDH2) and Vimentin (VIM). The role of SDF-1 for invasion and induction of EMT in breast cancer cells was analyzed by blocking SDF-1 secretion during co-culture with MG63 cells. In addition effects of KP-10 treatment on SDF-1-induced invasion and EMT were analyzed. Breast cancer cell invasion was significantly increased when co-cultured with MG63 cells. During co-culture SDF-1 protein expression of MG63 cells was significantly induced. The increased breast cancer cell invasion could be blocked by anti-SDF-1 antibodies. Treatment of breast cancer cells in monoculture (without MG63) with SDF-1α, SDF-1β or the combination of both isoforms resulted in a significant escalation of breast cancer cell invasion and induction of EMT. Protein expression of mesenchymal markers CDH2 and VIM was clearly elevated, whereas protein expression of epithelial marker CDH1 was clearly decreased. The SDF-1-induced increase of cell invasion was significantly reduced after treatment with KP-10. In addition, induction of EMT was inhibited. Furthermore, protein expression of the binding site of SDF-1, CXC-motive-chemokine receptor 4 (CXCR-4), was reduced by KP-10. Treatment of MCF-7-EMT cells with KP-10 resulted in a significant drop of cell invasion and CXCR-4 protein expression. Our findings suggest that SDF-1 plays a major role in breast cancer invasion and EMT. SDF-1-induced invasion and EMT can be inhibited by KP-10 treatment by down-regulating CXCR-4 expression.
    No preview · Article · Jun 2015 · Breast Cancer Research and Treatment
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    G. Emons · N. Maass · W. Jonat

    Preview · Article · Jun 2015 · Der Gynäkologe
  • G. Emons
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    ABSTRACT: Hintergrund Das Endometriumkarzinom (EC) ist in Deutschland die vierthäufigste maligne Erkrankung der Frau. Fragestellung Epidemiologie, Ätiologie, Diagnostik und Therapie des EC. Methode Systematische Auswertung der Literatur in Pubmed bis Dezember 2014 (Suchbegriff: „endometrial cancer“). Ergebnisse In Deutschland erkranken pro Jahr 11.550 Frauen neu an einem EC. Das EC zählt zu den prognostisch günstigen Malignomen, da es meist in einem frühen Stadium diagnostiziert wird. Hierfür sind Blutungen in der Postmenopause und im Senium sowie atypische Blutungen bei prämenopausalen Frauen sorgfältig abzuklären. Durch eine Hysterektomie mit beidseitiger Adnexexstirpation kann die Mehrzahl der EC-Patientinnen geheilt werden. Bei Tumoren mit hohem Rückfallrisiko wird die systematische Lymphonodektomie (pelvin und paraaortal), eine adjuvante Chemotherapie, eine vaginale Brachytherapie und ggf. eine perkutane Strahlentherapie empfohlen. Bei EC mit niedrigem Rezidivrisiko ist eine minimal-invasive Operation onkologisch sicher. Aussagekräftige Studien zur onkologischen Sicherheit minimal-invasiver Operationsmethoden bei EC mit hohem Rezidivrisiko liegen nicht vor.
    No preview · Article · Jun 2015 · Der Gynäkologe
  • C Gründker · O Hinsche · G Emons

    No preview · Article · May 2015 · Senologie - Zeitschrift für Mammadiagnostik und -therapie
  • R Girgert · G Emons · C Gründker

    No preview · Article · May 2015 · Senologie - Zeitschrift für Mammadiagnostik und -therapie
  • G Emons · M W Beckmann · D Schmidt · P Mallmann

    No preview · Article · Feb 2015 · Geburtshilfe und Frauenheilkunde
  • G. Emons
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    ABSTRACT: Wie in der Einleitung zum ersten Heft zu diesem Thema erwähnt (Der Gynäkologe 2012, 45:94) hatte es der Geburtshelfer bis vor wenigen Jahrzehnten weitestgehend mit gesunden jungen Frauen zu tun, die meist problemlos ihre Schwangerschaften austrugen und gebaren. Ärztliche Kompetenz war nur erforderlich, wenn typische geburtshilfliche Komplikationen während der Schwangerschaft oder peripartal auftraten. Dies ist heute anders: Dank der Fortschritte der Pädiatrie erreichen heute viele kranke junge Frauen, die vor einigen Jahrzehnten in der Kindheit verstorben wären, das reproduktive Alter. Dank der Fortschritte der inneren Medizin könne heute Frauen mit gravierenden internistischen Erkrankungen schwanger werden und die Schwangerschaft austragen, die früher nie konzipiert hätten oder denen man früher dringend zu einem Schwangerschaftsabbruch aus medizinischer Indikation geraten hätte. Viele Frauen realisieren ihre Reproduktion erst im letzten Abschnitt ihrer fertilen Lebensphase. Sie ...
    No preview · Article · Feb 2015 · Der Gynäkologe
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    Rainer Girgert · Günter Emons · Carsten Gründker
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    ABSTRACT: Background: Due to the lack of ERα, triple negative breast cancers (TNBCs) are not susceptible to endocrine therapy using antiestrogens. However, the majority of TNBCs express the membrane bound estrogen receptor GPR30. We have recently shown that knock-down of GPR30 expression prevented growth stimulation of TNBC cell lines by 17β-estradiol. Now we analyzed whether specific inhibition of GPR30 represents a new option for therapy of TNBC. Methods: Growth of TNBC cells was assessed using Alamar-blue colorimetric assay. Activation of c-Src and EGF-receptor was assessed using Western blots. Expression of c-fos, cyclin D1 and aromatase was quantified by RT-PCR. Gα-specific signaling of GPR30 was analyzed by electrophoretic mobility shift assay. Results: HCC1806 cells showed the highest GPR30 expression, in HCC70 cells it was clearly lower, in MDA-MB-231 cells it was lowest. 10-8 M 17β-estradiol significantly increased proliferation of HCC1806 cells to 134 ± 12% of control (p < 0.01). Proliferation of HCC70 cells was slightly increased to 116 ± 8% of control. Estriol significantly reduced cell number of HCC1806 cells to 16 ± 12% (p < 0.01). Cell number of HCC70 cells and of MDA-MB-231 cells was reduced to 68 ± 25% and to 61 ± 10%, respectively. Conclusion: Specific pharmacological inhibition of GPR30 might become a promising targeted therapy for TNBC in future.
    Full-text · Article · Dec 2014 · BMC Cancer
  • Gerd Bauerschmitz · Agnieszka Opiela · Günter Emons

    No preview · Article · Dec 2014 · Frauenheilkunde up2date
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    Prof. Dr. W. Janni · G. Emons · W. Jonat

    Preview · Article · Dec 2014 · Der Gynäkologe
  • Source
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    ABSTRACT: Metastasis to bone is a frequent problem of advanced breast cancer. Particularly breast cancers, which do not express estrogen receptor α (ERα) and progesterone receptor (PR) and which have no overexpression of human epidermal growth factor receptor 2 (HER2), so‑called triple‑negative breast cancers (TNBCs), are considered as very aggressive and have a poor prognosis. Recently we have shown that breast cancer cell invasion was dramatically increased when co‑cultured with MG63 osteoblast‑like cells. Using this model we have now analyzed whether estrogen receptor β (ERβ) plays a role in TNBC cell invasion in vitro. ERα and ERβ protein expression was analyzed using western blot analysis. Invasion was quantified by assessment of TNBC cell migration rate through an artificial basement membrane in a modified Boyden chamber during co‑culture with MG63 osteoblast‑like cells. The effects of ERβ agonist treatment on CXC motif chemokine receptor 4 (CXCR4) protein expression during co‑culture with MG64 cells was quantified using western blot analysis. Proliferation was measured using alamarBlue assay. TNBC cell lines HCC1806 and HCC1937 showed no ERα but high ERβ protein expression. Cell invasion of HCC1806 and HCC1937 TNBC cells was significantly increased when co‑cultured with MG63 osteoblast‑like cells. Treatment with ERβ selective estrogen agonists liquiritigenin and ERB‑041 reduced the ability to invade a reconstituted basement membrane and to migrate in response to the cellular stimulus. During co‑culture CXCR4 protein expression of TNBC cell lines HCC1806 and HCC1937 was significantly increased. Treatment with liquiritigenin resulted in a significant decrease of CXCR4 protein expression. Both ERβ agonists showed no effect on TNBC cell proliferation. Our findings suggest that ERβ plays a major role in TNBC invasion. Bone‑directed invasion can be inhibited by ERβ agonists.
    Full-text · Article · Nov 2014 · International Journal of Oncology
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    ABSTRACT: Epithelial-mesenchymal transition (EMT) is a cellular development program characterized by loss of cell adhesion and increased cell mobility. It is essential for numerous processes including metastasis. In this study we have generated "aggressive" MCF-7 breast cancer cells (MCF-7-EMT), which show significantly increased invasion in contrast to wild type MCF-7 (MCF-7 WT) cells. In addition, we have analyzed, whether these cell lines differ in their metastatic behavior in vivo and in expression of invasion and/or EMT-relevant genes. Invasive behavior of different human breast cancer cell lines was tested. "Aggressive" MCF-7 cells (MCF-7-EMT) were generated using coculture and mammosphere culture techniques. To analyze whether or not MCF-7-EMT cells in contrast to MCF-7 WT cells form metastases in vivo, we assessed metastases in a nude mouse model. mRNA expression profiles of MCF-7 WT cells and MCF-7-EMT cells were compared using the Affymetrix micro array technique. Expression of selected genes was validated using real-time PCR. In addition, protein expression of epithelial marker E-cadherin (CDH1) and mesenchymal markers N-cadherin (CDH2), Vimentin (VIM), and TWIST was compared. The breast cancer cell lines showed different invasive behavior from hardly any invasion to a stronger cell movement. Coculture with osteoblast-like MG63 cells led to significantly increased cell invasion rates. The highest increase was shown using MCF-7 WT cells. Generated MCF-7-EMT cells showed significantly increased invasion as compared to MCF-7 WT cells. In 8 of 10 mice bearing orthotopically growing MCF-7-EMT tumors, we could detect metastases in liver and lung. In mice bearing MCF-7 WT tumors (n = 10), no metastases were found. MCF-7 WT cells and MCF-7-EMT cells were different in expression of 325 genes. Forty-four of the most regulated 50 invasion and/or EMT-related genes were upregulated and 6 genes were downregulated in MCF-7-EMT cells. Protein expression of mesenchymal markers CDH2, VIM, and TWIST was clearly increased in MCF-7-EMT cells. Protein expression of epithelial marker CDH1 was clearly decreased. With the breast cancer cell lines, MCF-7-EMT and MCF-7 WT cells, we have an excellent model of cells for further studies of EMT and invasion in vitro and in vivo.
    No preview · Article · Oct 2014 · Breast Cancer Research and Treatment

  • No preview · Article · Sep 2014 · Geburtshilfe und Frauenheilkunde

Publication Stats

6k Citations
786.32 Total Impact Points


  • 2006-2015
    • Universitätsmedizin Göttingen
      • Department of Gynecology and Obstetrics
      Göttingen, Lower Saxony, Germany
    • Universitätsklinikum Erlangen
      Erlangen, Bavaria, Germany
  • 1998-2015
    • Georg-August-Universität Göttingen
      • • Department of Experimental Psychology
      • • Faculty of Medicine
      Göttingen, Lower Saxony, Germany
  • 2014
    • Friedrich-Alexander Universität Erlangen-Nürnberg
      Erlangen, Bavaria, Germany
  • 2011-2012
    • Universitätsklinikum Freiburg
      • Department of Obstetrics and Gynaecology
      Freiburg an der Elbe, Lower Saxony, Germany
  • 2005
    • Ludwig-Maximilians-University of Munich
      • Clinic and Polyclinic for Obstetrics and Gynecology
      München, Bavaria, Germany
  • 2004
    • Universität Regensburg
      Ratisbon, Bavaria, Germany
  • 1985-2003
    • Universität zu Lübeck
      • • Klinik für Augenheilkunde
      • • Department of Obstetrics and Gynecology
      • • Klinik für Frauenheilkunde und Geburtshilfe
      Lübeck Hansestadt, Schleswig-Holstein, Germany
    • Hannover Medical School
      Hanover, Lower Saxony, Germany
  • 2000
    • University of Hamburg
      Hamburg, Hamburg, Germany
  • 1990-1999
    • Philipps-Universität Marburg
      • Klinik für Gynäkologie, Gynäkologische Endokrinologie und Onkologie (Marburg)
      Marburg, Hesse, Germany
    • West Georgia Obstetrics and Gynecology
      Georgetown, Georgia, United States
  • 1988
    • National Institutes of Health
      • Section on Reproductive Endocrinology
      베서스다, Maryland, United States
  • 1984
    • Eunice Kennedy Shriver National Institute of Child Health and Human Development
      Роквилл, Maryland, United States