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Biomedical subjects

S Böhmer

Publications and source records attributed to S Böhmer.

At least 19 recordsLinked to original sources

Patient with trisomy 6 mosaicism.

Trisomy 6 and trisomy 6 mosaicism were found in chorionic villi cell culture and short term incubation in a prenatal diagnosis at 12 weeks of gestation in a pregnancy with a growth retarded fetus showing nuchal translucency. The child was born in the 25th gestational week with a number of malformations including heart defects, deep-set ears, cleft right hand, cutaneous syndactylies, and overlapping toes of irregular shape and length. Trisomy 6 was not found in peripheral blood lymphocytes but was confirmed in umbilical cord fibroblasts. Currently, at the age of 2-3/4 years, the development of the child is relatively normal despite considerable growth delay. At the age of two years, she developed a papular erythema clinically suggestive of epidermal nevi. Cytogenetic analysis of fibroblast cultures derived from skin from a right hand finger and the inguinal area confirmed the presence of a trisomy 6 mosaicism. This is the first observation of a liveborn with trisomy 6 mosaicism.

Child, Preschool↗

[Typical forms of choriocarcinoma in clinical practice--diagnosis and therapeutic course in four patients].

The paper reports on four patients with choriocarcinoma. In two of them, the choriocarcinoma was found after abortion, in one of them following termination of pregnancy, and in the last patient a hydatidiform mole was present. In all patients increased beta-HCG was found. One patient had lung metastasis at the time of diagnosis. In another patient, choriocarcinoma was suspected owing to ultrasonographic vaginal examination. According to the Bagshawe Score, 3 patients were low-risk and were subjected to methotrexate. One patient was medium-risk and received PEB chemotherapy. All four patients are regarded as cured.

Abortion, Induced↗

Does texture analysis improve breast ultrasound precision?

OBJECTIVE: To evaluate the possibility of distinguishing between benign and malignant breast tumors using a computer-aided evaluation of echogenicity and echostructure of ultrasound findings at certain focal points. STUDY DESIGN: The ultrasound images from 89 cases of breast tumor were documented under standardized conditions using a linear array machine and 7.5 MHz transducer. In each sonographic image, the maximum area of the 'region of interest' of the tumor was marked and then subjected to consecutive statistical analysis and correlation with the histological findings. For evaluation of tumor status eight parameters of first and second order texture statistics (gray level histogram, Fourier analysis, co-occurrence matrix) were applied. RESULTS: Benign tumors were clearly distinguished from carcinomas in the evaluation of the co-occurrence matrix and the Fourier analysis on the basis of Wilcoxon and Student t-test (P < 0.05) but not in the gray level histogram. Using logistic regression a sensitivity of 73.8% and a specificity of 54.2% were obtained. A statistically significant difference between benign tumors and moderately differentiated together with poorly differentiated carcinomas could be demonstrated. CONCLUSION: This study concludes that texture analysis appears to distinguish between benign and most malignant tumors. A computer texture analyzing system is able to improve the subjective assessment of ultrasound images of the breast but can not replace it. Where the limits of subjective assessment of a given tumor are reached, computerized texture analysis will provide additional information in the differentiation of benign from malignant findings.

Breast Neoplasms↗

[Pronounced bilateral mammary hypertrophy as a rare manifestation of acute lymphatic leukemia].

A 33-year-old patient, hitherto healthy, has been admitted for clarification of bilateral mammary hypertrophy. In the course of the usual routine examination a lump of the size of a cherry was identified in the right breast. Within 6 weeks both breasts had become tight and grown symmetrically to three times their original size. A provisionary diagnosis of high malignant non-hodgkin lymphoma was made by multiple high speed needle biopsies and was later confirmed by a surgical tissue specimen of the right breast. For further classification a bone-marrow biopsy was taken from the pelvic bone and an immature acute lymphoblastic leukemia (ALL), known as preB1-ALL, diagnosed. Sonographic examination, computer tomography of the thorax and mammographical findings, as well as symptoms, outcome and differential diagnosis of a proliferative lymphatic disease with first manifestation in both breasts are presented and discussed.

Adult↗

[Efficacy of ultrasound screening in pregnancy].

OBJECTIVE: The purpose of this study was to examine the effectiveness of ultrasound screening in pregnancy. MATERIAL AND METHODS: Therefore, it was registered whether fetal malformations in a study population of 11,172 deliveries were already diagnosed before birth. RESULTS: 341 defects were found in 297 children from mothers who had had prenatal care. Most anomalies were seen in the urogenital tract (n = 98; 28.7%), the heart (n = 67; 19.6%), the connective tissue (n = 39; 11.4%), the gastrointestinal tract (n = 32; 9.4%), and in the central nervous system (n = 33; 9.7%). Chromosomal anomalies (n = 22; 6.5%) and orofacial defects (n = 21; 6.2%) were more rare. 8.8% of all defects were lethal, 37% severe. 237 (69.5%) were classified as "diagnosable by ultrasound prenatally". 125 of them (53%) were identified prenatally, with high rates of 71% in central nervous system, 65.5% in intestinal and 54% in urogenital tract, while the detection rate was only 13.6% in chromosomal and 3.3% in cardiac defects. Only 14.3% were found before 24 weeks of gestation. CONCLUSIONS: Thus, the effectiveness of ultrasound screening has to be improved by adequate measures.

Adolescent↗

Oxidation of phenanthrene by a fungal laccase in the presence of 1-hydroxybenzotriazole and unsaturated lipids.

Phenanthrene, a polycyclic aromatic hydrocarbon, was efficiently oxidized by laccase in the presence of both 1-hydroxybenzotriazole and unsaturated lipids. 73% of initially added phenanthrene was degraded within 182 hours to give phenanthrene-9,10-quinone and 2,2'-diphenic acid as the major products. The system was also able to peroxidize linoleic acid to its corresponding hydroperoxides suggesting the involvement of lipid peroxidation in laccase catalyzed phenanthrene oxidation. Lipid peroxidation by laccase required 1-hydroxybenzotriazole and did not depend on Mn2+ and H2O2 suggesting that the chemical reactions involved differ from those previously reported for manganese peroxidase.

Basidiomycota↗

[Texture analysis: a new method for evaluating ultrasound imaged lesions of the breast].

Echogenicity and echostructure in sonomammography are essential criteria to determine the malignancy of a breast tumor. Looking for a correlation between echostructure of an ultrasound image and its histopathology a texture analysis was performed. Ultrasonic examinations were carried out by means of a 7.5-MHz linear scanner under standardized conditions. 71 mammasonographic findings were documented by video tape, each tumor in 2 dimensions. In a second step 'the region of interest', that means the whole tumor area, was marked and statistically analyzed by a dedicated computer system. The values of 23 first- and second-order statistical texture parameters were compared with the histopathology of the tumor. They include grey level histogram, Fourier analysis and cooccurrence matrix. The most important results were obtained in the histogram analysis. An obvious distinction could be worked out concerning carcinomas, adenomas, mastopathic tumors, and fat necrosis. Except the difference between carcinomas and adenomas this distinction was statistically significant. Fourier analysis and coocurrence matrix significantly separate fibrocystic lesions, fat necrosis, scars, and cystic structures from malignant tumors. Furthermore the maximum value method was used to compare the different parameters with regard to their capability of discriminating benign and malignant tumors. The extreme values of 100% were mostly observed in the case of seromas and scars. A significant difference was found by histological grading of carcinomas, too. Highly differenciated carcinomas show capability of results comparable to those of adenomas. By means of a computer texture analysis program it is possible to find a correlation between echostructure and histopathology of breast tumors.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗

[Vaginal sonography in follow-up of early pregnancies--applications in general practice of established gynecologists].

In 541 early pregnant women transvaginal sonography (TVS) was performed between 5th and 9th week of gestation. The correct gestational age was verified and information on normal development of the embryo was collected with this routine sonographic control. In one-third of 541 patients disturbances of the pregnancy were found directly or a TVS control was recommended. In 116 cases the gestational age, determined by calculating the period since the last menstruation, had to be corrected by sonographic results. In 12 women ectopic pregnancies without any symptoms were found. Only 47 women of 251 evaluated patients had no risk in pregnancy.

Abortion, Spontaneous↗

[Comparison of vaginal and abdominal ultrasound measurements with embryologic growth curves in early pregnancy].

Body lengths and chorionic diameters of 225 early pregnancies with known fertilisation age, measured by transvaginal sonography (TVS), were compared with measuring results of measurements from abdominal ultrasound and of embryological specimen from the literature. The TVS measuring results were made according to the Carnegie classification. It is shown that the growth curve obtained by TVS is very similar to valid embryological growth curves, although the "Greatest Length" (GL) is measured by sonography not the Crown-Rump-Length (CRL). Between the sixth and eighth gestational week, the TVS curve shows strong resemblance to abdomino-sonographical curves. After that period, the TVS results tend to be systematically lower. The earliest TVS measurement of the human embryo in possible in the sixth gestational week, one week earlier than with abdominal ultrasound. There is a good correlation between the development of a structure and its earliest detection by TVS, active movements of the embryo can even be shown earlier than assumed by embryologists (stage 20/ninth week of gestation). Due to terminological reasons, in ultrasound the established term "Crown-Rump-Length" should be replaced by "Greatest Length". In a TVS-examination of an embryo (gestational weeks 4 to 11), morphological criteria must be additional contributions to the determination of maturity and integrity of a pregnancy. The application of the specimen-derived Carnegie classification to TVS measurements seem to be possible, as well as the utilization of TVS results in embryology.

Adult↗

[Comparative studies of the uterine cervix in pregnancy using palpation and vaginal sonography].

Ultrasonography and manual palpation were used to evaluate the uterine cervix of 71 pregnant women between 14th and 36th week of gestational age. The sonographic length of the uterine cervix was about 4.2 cm according to the relevant cervix palpation (Group I), about 3.2 cm in the moderately shortened cervix (Group II) and about 2.8 cm in the severely shortened cervix (Group III). The distance between the surface of the ectocervix to the urinary bladder corresponded to the cervical palpation showing a constant difference of about 0.5 cm. No difference could be found in the width of the upper cervix. The index was determined as ratio of the sonographically ascertained cervical length and width of the supravaginal cervix. A value of 0.8 or lower describes a cervical incompetence of a higher degree and signifies an unfavourable prognosis. The evaluation of cervical incompetence and the relevance of the sonographically detected opened internal os have not yet been clarified. A hitherto unsolved problem is the dilatation of the cervical canal in case of immature palpatory findings with traumatic anamnesis.

Adult↗

[Transvaginal ultrasonic assessment of the endometrium in menopause].

Early detection of endometrial cancer is hardly possible. In nearly 90% of all cases irregular vaginal bleeding is the first clinical sign of this disease. New ultrasound technique, small scanner probes and especially higher ultrasound frequencies rendered a better resolving power and higher quality medical imaging. Hence, now the examination of the organs in the female pelvis is very exact using vaginal sonography (VS). A clinical study was performed to examine the relevance of VS assessing changes and details of the endometrium. In particular, the sonographical criteria of early endometrial cancer should be defined. In 137 postmenopausal women VS was performed after irregular vaginal bleeding and prior to D&C. All findings were described concerning alteration in echogenicity and thickness of the endometrium. Only one case of 37 histological confirmed endometrial cancers among the study group was not detected by VS prior to curettage. Therefore 0.7% of the sonographical findings showed a false negative result and 6.6% were false positive in comparison to the histological outcome. VS seems to be a relatively reliable technique in assessing the endometrium. In conclusion VS could be a useful additional method to detect hyperplasia or malignant disorders of the endometrium.

Adult↗

[Vaginal ultrasound follow-up of suspicious smears of the cervix uteri].

Using transvaginal sonography (TVS) it is possible to place the scanner probe very close to the organs of the female small pelvis. The near position allows the employment of a higher ultrasound frequency with a better resolving power and thus with more information about the examined structures. A clinical study was performed to investigate whether it is possible to gain some more information about alterations of the uterine cervix surface, after a suspicious cytology result, by applying TVS. A total 59 women with a pathological swab were examined, followed by conisation (using an operating knife) and a D & C. Histological examination showed that in 21 cases with sonographically not suspicious results, 10 cancers in situ and 1 early invasive squamous cell cancer could not be detected. The determined sensitivity of the method was 30.8%; the specificity was 59%. Concluding from the result TVS can be applied only with restriction concerning detection of beginning cancer of the uterine cervix. A statistical significance of vaginosonographical results compared with the suspicious smear results could not be established.

Adult↗

Plasma oxytocin but not prostaglandin F2 alpha metabolite levels at cerclage may predict preterm delivery.

Plasma oxytocin and prostaglandin F2 alpha metabolite (PGFM) concentrations were measured in 45 patients admitted for cerclage during the second trimester. Samples were collected before, 3 hours after, and 3 days after the Shirodkar procedure. Uterine activity was recorded by external tocography twice daily for 30 minutes. Twenty-eight women with uncomplicated pregnancy and commensurate gestational age served as controls. Cervical length, measured by ultrasonography, was significantly shorter before cerclage (36 +/- 2 mm) than after cerclage (43 +/- 2 mm) or compared with controls (48 +/- 1 mm). Bishop scores ranged from 3-6 (median 4) in the cerclage group and 0-1 (median 0) in controls. Fifteen cerclage patients and one control delivered preterm 5-22 weeks after the procedure. Initial plasma PGFM levels were significantly higher in cerclage patients than in controls. The cerclage procedure caused an immediate rise in plasma PGFM and a subsequent fall below initial levels to control values. Neither the initial levels of PGFM nor the increments 3 hours after cerclage correlated with the outcome of pregnancy. By contrast, plasma oxytocin levels before cerclage were significantly higher in patients who subsequently delivered preterm than in those who delivered at term. Cerclage resulted in a significant fall in plasma oxytocin at 3 hours in patients with preterm delivery, but after 3 days the oxytocin levels had returned to the precerclage values. Patients who had increased uterine contractions had significantly higher plasma oxytocin levels but lower PGFM levels than those without contractions.(ABSTRACT TRUNCATED AT 250 WORDS)

Dinoprost↗

[Trans-vaginal sonography in gynecological practice].

Some 1,077 transvaginal ultrasonic studies performed in the gynecologist's office are reported. The US technique employed was particularly useful, since, in combination with the pelvic examination, it permitted rapid and accurate diagnosis. Patient acceptance was very high. Both in the gynecological and obstetric examinations, pathological findings were established in about 30% of the cases. In the diagnostic evaluation of both pre- and post-menopausal endometrium, and of the uterine cervix in advanced pregnancies, transvaginal ultrasonography opens up new diagnostic possibilities that can lead to a selective indication for D & C and cerclage.

Female↗

[Immunological factors in extracorporeal fertilization. The role of antibodies against spermatozoa and zona pellucida antigen].

Immunologic disturbances must be considered a major cause of unexplained infertility. To evaluate the influence of sperm antibodies (SPAB) and zona pellucida antibodies (ZPAB) on the pregnancy rate, we have screened patients treated by in-vitro fertilization (IVF) and embryo transfer (ET) in the Department of Obstetrics and Gynecology of the School of Medicine, Hannover, for the presence of sperm antibodies and zona pellucida antibodies in the serum, cervical mucus and uterine secretions, and also in the serum and ejaculate of the husbands. After embryo transfer the concentrations of progesterone and beta-hCG in the sera were determined to evaluate the luteal phase and to detect early pregnancy. Among 122 women 11 clinical pregnancies were achieved; 8 of these pregnant women showed negative antibody reactions, while only 3 women with significant positive reactions for SPAB or ZPAB became pregnant. Only one pregnancy occurred in 24 women with high ZPAB titers. In conclusion, determinations of SPAB- and ZPAB-titers in serum and genital secretions are highly recommended in the evaluation of infertile couples.

Antigens↗

[Cholesterol granulomatosis of the lungs].

The cholesterol storage disease of the lung is seldom and therefore we hardly think of it. An evident diagnosis can be given only by histological examinations. 2 cases are described where during life was diagnosed a silicosis and declared as an occupational disease. Autopsy revealed cholesterol storage disease without any signs of silicosis. These findings suggest, that in cases with low occupational quartz-dust-exposure it is advisable to extend the field of diagnostic procedures.

Cholesterol↗

[Vaginal sonography as a method of study in the evaluation of cervix insufficiency. A useful complement to vaginal palpation?].

In a clinical study a group of pregnant women with suspected cervical incompetence was examined by vaginal sonography. Aim of the investigation was to compare results of performed vaginal palpation with results of sonography. 53 pregnant women between 20th und 31st week of gestation were examined by a 5 MHz vaginal sector-scanner probe. After focussing sagittal projection of uterine cervix and lower uterine segment the cervical length and opening of the internal os were assessed prior to cerclage. Postoperative vaginal sonography was performed to ascertain lengthening and stabilization of the incompetent cervix. Comparing results of vaginal palpation and vaginal sonography showed, that the cervical length obtained by sonography was constantly higher in all patients than the results obtained by palpation. This difference became more distinct in the group of patients with extreme cervical incompetence. We are of the opinion that vaginal sonography is an objective method revealing the extent of cervical incompetence. Exact measurement of the cervical length and assessment of the internal os are efficient diagnostic criteria. They complete results of cervical palpation and offer precise information concerning an intended cerclage.

Adolescent↗