Supplementary Figure 4 from Intratumoral Cytokines and Tumor Cell Biology Determine Spontaneous B... more Supplementary Figure 4 from Intratumoral Cytokines and Tumor Cell Biology Determine Spontaneous Breast Cancer–Specific Immune Responses and Their Correlation to Prognosis
Supplementary Figure 5 from Intratumoral Cytokines and Tumor Cell Biology Determine Spontaneous B... more Supplementary Figure 5 from Intratumoral Cytokines and Tumor Cell Biology Determine Spontaneous Breast Cancer–Specific Immune Responses and Their Correlation to Prognosis
Supplementary Table 2 from Intratumoral Cytokines and Tumor Cell Biology Determine Spontaneous Br... more Supplementary Table 2 from Intratumoral Cytokines and Tumor Cell Biology Determine Spontaneous Breast Cancer–Specific Immune Responses and Their Correlation to Prognosis
Background: Isolated fetal ascites can be caused by many heterogeneous disorders and is associate... more Background: Isolated fetal ascites can be caused by many heterogeneous disorders and is associated with a variety of conditions. Cloacal anomalies are rare abnormalities with a highly variable array of sonographic symptoms, which make them difficult to diagnose antenatally. We present a case with isolated fetal ascites without hydronephrosis caused by a cloacal malformation. Case: A 28-year-old woman, gravida 2, para 1, was referred to our unit at 18 weeks gestation with a hyperdense structure in the fetal liver. Cordocentesis revealed a normal karyotype and negative viral titers. Isolated fetal ascites occurred for the first time at 23 weeks gestation. Serial ultrasounds showed progressive fetal ascites with no hydronephrosis at any time and no other malformations apart from the previously diagnosed hyperechogenic liver structure. After the insertion of an abdomino-amniotic shunt, a temporary reduction of the sonographically detectable ascites could be achieved. Cesarean delivery w...
Non-invasive prenatal testing (NIPT) is often erroneously received as a diagnostic procedure due ... more Non-invasive prenatal testing (NIPT) is often erroneously received as a diagnostic procedure due to its high discriminatory power in the field of fetal trisomy 21 diagnosis (wording: “NIPT replaces amniocentesis”). Already a look at the methodology of NIPT (statistical gene dose comparison of a primarily maternofetal DNA mixture information at selected sites of the genome) easily reveals that NIPT cannot match the gold standard offered by cytogenetic and molecular genetic analysis procedures from the matrix of the entire human genome (origin: vital fetal cells), neither in diagnostic breadth nor in diagnostic depth. In fact, NIPT in fetal medicine in its current stage of development is a selective genetic search procedure, which can be applied in primary (without indication) or secondary (indication-related) screening. Thus, NIPT competes with established search procedures for this field. Here, the combined nuchal translucency (NT) test according to Nicolaides has become the worldwi...
Die bildgebenden Verfahren nehmen in der gynakologischen Diagnostik eine zentrale Stelle ein. Gru... more Die bildgebenden Verfahren nehmen in der gynakologischen Diagnostik eine zentrale Stelle ein. Grundsatzlich stehen 3 Methoden zur Verfugung: 1. Ultraschall; 2. Rontgendiagnostik; 3. Kernspintomographie.
Mirror syndrome is a rare and serious maternal condition associated with immune and non-immune fe... more Mirror syndrome is a rare and serious maternal condition associated with immune and non-immune fetal hydrops after 16 weeks of gestational age. Subjacent conditions associated with fetal hydrops may carry different risks for Mirror syndrome. Fetuses with Turner syndrome are frequently found to be hydropic on ultrasound. We designed a retrospective multicenter study to evaluate the risk for Mirror syndrome among pregnancies complicated with Turner syndrome and fetal hydrops. Data were extracted from a questionnaire sent to specialists in maternal fetal medicine in Germany. Out of 758 cases, 138 fulfilled our inclusion criteria and were included in the analysis. Of the included 138, 66 presented with persisting hydrops at or after 16 weeks. The frequency of placental hydrops/placentomegaly was rather low (8.1%). Of note, no Mirror syndrome was observed in our study cohort. We propose that the risk of this pregnancy complication varies according to the subjacent cause of fetal hydrops....
OBJECTIVE: Fetal macrosomia is ranked among the main complications of gestational diabetes (GDM).... more OBJECTIVE: Fetal macrosomia is ranked among the main complications of gestational diabetes (GDM). The aim of this study was the detailed monitoring of fetometric parameters in GDM under clinical conditions when normoglycemia was aimed for and the search for differing fetal growth patterns. MATERIAL AND METHODS: In 152 pregnancies affected by GDM, 746 ultrasound examinations conducted between the 20th and 40th week of gestation, each consisting of seven fetometric measurements, were evaluated. 1040 non-diabetic single pregnancies served as controls. Subgroups were made according to BMI and applied therapy and analyzed for differences. RESULTS: Compared to the control group, all seven ultrasound parameters revealed nearly identical growth patterns. Regarding the subgroup analysis of each individual ultrasound parameter, no significant constant difference could be observed. On average, a comparable development was observed in all groups. The overall small-for-gestation-age (SGA) rate amounted to 20 %, mothers with a BMI > 30 kg/m 2 revealed the highest rate of 28 %. CONCLUSIONS: Despite achieving normoglycemia and on average eutrophic fetuses, currently applied modern therapeutic criteria in GDM including regular fetometric ultrasound monitoring can not avoid the development of markedly high SGA rates. Therefore, these approaches must be considered as not suitable for achieving precise control of fetal growth.
Zeitschrift für Geburtshilfe und Neonatologie, 2001
PURPOSE Although ultrasound examination became almost indispensable in prenatal diagnosis as well... more PURPOSE Although ultrasound examination became almost indispensable in prenatal diagnosis as well as in gynecological examination, there are still a lot of deficits in the quality management of medical education. We present a "ultrasound simulation system", that makes it possible to simulate a complete ultrasound examination. The system is able to simulate all imaginable kinds of ultrasound examination. MATERIAL AND METHODS At the Department of Gynecology and Obstetrics of the "Medizinische Hochschule Hannover" 115 banks of normal and 29 banks of pathologic volumes were scanned and stored into our newly developed "ultrasound simulation system". 7 physicians had to examine 10 "virtual" cases each; we evaluated the incidence of positive and negative results. Furthermore, the physicians had to evaluate the quality of visualization with a score. RESULTS 12 of 14 malformations were identified as "fetal anomalies", whereas 2 fetal anomalies could not be identified correctly. All 56 healthy fetuses could be identified to be normal. The quality of visualization was regarded to be good in 62 cases, sufficient in 6 cases and poor in 2 cases. CONCLUSION The "ultrasound simulation system" enables users to test and improve their levels of skill to detect pathologic findings in gynecological and obstetrical examinations. At the same time the system gives the instructor the possibility to test the quality of medical examinations. The integration of ultrasound training with an ultrasound simulation system into medical education should be discussed to improve the general level of skill in gynecological ultrasound.
Supplementary Figure 4 from Intratumoral Cytokines and Tumor Cell Biology Determine Spontaneous B... more Supplementary Figure 4 from Intratumoral Cytokines and Tumor Cell Biology Determine Spontaneous Breast Cancer–Specific Immune Responses and Their Correlation to Prognosis
Supplementary Figure 5 from Intratumoral Cytokines and Tumor Cell Biology Determine Spontaneous B... more Supplementary Figure 5 from Intratumoral Cytokines and Tumor Cell Biology Determine Spontaneous Breast Cancer–Specific Immune Responses and Their Correlation to Prognosis
Supplementary Table 2 from Intratumoral Cytokines and Tumor Cell Biology Determine Spontaneous Br... more Supplementary Table 2 from Intratumoral Cytokines and Tumor Cell Biology Determine Spontaneous Breast Cancer–Specific Immune Responses and Their Correlation to Prognosis
Background: Isolated fetal ascites can be caused by many heterogeneous disorders and is associate... more Background: Isolated fetal ascites can be caused by many heterogeneous disorders and is associated with a variety of conditions. Cloacal anomalies are rare abnormalities with a highly variable array of sonographic symptoms, which make them difficult to diagnose antenatally. We present a case with isolated fetal ascites without hydronephrosis caused by a cloacal malformation. Case: A 28-year-old woman, gravida 2, para 1, was referred to our unit at 18 weeks gestation with a hyperdense structure in the fetal liver. Cordocentesis revealed a normal karyotype and negative viral titers. Isolated fetal ascites occurred for the first time at 23 weeks gestation. Serial ultrasounds showed progressive fetal ascites with no hydronephrosis at any time and no other malformations apart from the previously diagnosed hyperechogenic liver structure. After the insertion of an abdomino-amniotic shunt, a temporary reduction of the sonographically detectable ascites could be achieved. Cesarean delivery w...
Non-invasive prenatal testing (NIPT) is often erroneously received as a diagnostic procedure due ... more Non-invasive prenatal testing (NIPT) is often erroneously received as a diagnostic procedure due to its high discriminatory power in the field of fetal trisomy 21 diagnosis (wording: “NIPT replaces amniocentesis”). Already a look at the methodology of NIPT (statistical gene dose comparison of a primarily maternofetal DNA mixture information at selected sites of the genome) easily reveals that NIPT cannot match the gold standard offered by cytogenetic and molecular genetic analysis procedures from the matrix of the entire human genome (origin: vital fetal cells), neither in diagnostic breadth nor in diagnostic depth. In fact, NIPT in fetal medicine in its current stage of development is a selective genetic search procedure, which can be applied in primary (without indication) or secondary (indication-related) screening. Thus, NIPT competes with established search procedures for this field. Here, the combined nuchal translucency (NT) test according to Nicolaides has become the worldwi...
Die bildgebenden Verfahren nehmen in der gynakologischen Diagnostik eine zentrale Stelle ein. Gru... more Die bildgebenden Verfahren nehmen in der gynakologischen Diagnostik eine zentrale Stelle ein. Grundsatzlich stehen 3 Methoden zur Verfugung: 1. Ultraschall; 2. Rontgendiagnostik; 3. Kernspintomographie.
Mirror syndrome is a rare and serious maternal condition associated with immune and non-immune fe... more Mirror syndrome is a rare and serious maternal condition associated with immune and non-immune fetal hydrops after 16 weeks of gestational age. Subjacent conditions associated with fetal hydrops may carry different risks for Mirror syndrome. Fetuses with Turner syndrome are frequently found to be hydropic on ultrasound. We designed a retrospective multicenter study to evaluate the risk for Mirror syndrome among pregnancies complicated with Turner syndrome and fetal hydrops. Data were extracted from a questionnaire sent to specialists in maternal fetal medicine in Germany. Out of 758 cases, 138 fulfilled our inclusion criteria and were included in the analysis. Of the included 138, 66 presented with persisting hydrops at or after 16 weeks. The frequency of placental hydrops/placentomegaly was rather low (8.1%). Of note, no Mirror syndrome was observed in our study cohort. We propose that the risk of this pregnancy complication varies according to the subjacent cause of fetal hydrops....
OBJECTIVE: Fetal macrosomia is ranked among the main complications of gestational diabetes (GDM).... more OBJECTIVE: Fetal macrosomia is ranked among the main complications of gestational diabetes (GDM). The aim of this study was the detailed monitoring of fetometric parameters in GDM under clinical conditions when normoglycemia was aimed for and the search for differing fetal growth patterns. MATERIAL AND METHODS: In 152 pregnancies affected by GDM, 746 ultrasound examinations conducted between the 20th and 40th week of gestation, each consisting of seven fetometric measurements, were evaluated. 1040 non-diabetic single pregnancies served as controls. Subgroups were made according to BMI and applied therapy and analyzed for differences. RESULTS: Compared to the control group, all seven ultrasound parameters revealed nearly identical growth patterns. Regarding the subgroup analysis of each individual ultrasound parameter, no significant constant difference could be observed. On average, a comparable development was observed in all groups. The overall small-for-gestation-age (SGA) rate amounted to 20 %, mothers with a BMI > 30 kg/m 2 revealed the highest rate of 28 %. CONCLUSIONS: Despite achieving normoglycemia and on average eutrophic fetuses, currently applied modern therapeutic criteria in GDM including regular fetometric ultrasound monitoring can not avoid the development of markedly high SGA rates. Therefore, these approaches must be considered as not suitable for achieving precise control of fetal growth.
Zeitschrift für Geburtshilfe und Neonatologie, 2001
PURPOSE Although ultrasound examination became almost indispensable in prenatal diagnosis as well... more PURPOSE Although ultrasound examination became almost indispensable in prenatal diagnosis as well as in gynecological examination, there are still a lot of deficits in the quality management of medical education. We present a "ultrasound simulation system", that makes it possible to simulate a complete ultrasound examination. The system is able to simulate all imaginable kinds of ultrasound examination. MATERIAL AND METHODS At the Department of Gynecology and Obstetrics of the "Medizinische Hochschule Hannover" 115 banks of normal and 29 banks of pathologic volumes were scanned and stored into our newly developed "ultrasound simulation system". 7 physicians had to examine 10 "virtual" cases each; we evaluated the incidence of positive and negative results. Furthermore, the physicians had to evaluate the quality of visualization with a score. RESULTS 12 of 14 malformations were identified as "fetal anomalies", whereas 2 fetal anomalies could not be identified correctly. All 56 healthy fetuses could be identified to be normal. The quality of visualization was regarded to be good in 62 cases, sufficient in 6 cases and poor in 2 cases. CONCLUSION The "ultrasound simulation system" enables users to test and improve their levels of skill to detect pathologic findings in gynecological and obstetrical examinations. At the same time the system gives the instructor the possibility to test the quality of medical examinations. The integration of ultrasound training with an ultrasound simulation system into medical education should be discussed to improve the general level of skill in gynecological ultrasound.
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