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P Wunderbaldinger

Publications and source records attributed to P Wunderbaldinger.

44 records · Page 3Linked to original sources
PubMed1997

Mammography in women undergoing hormone replacement therapy. Possible effects revealed at routine examination.

PURPOSE: A retrospective study of screen-film mammographs was performed in 960 postmenopausal women to evaluate the possible effects of hormonal replacement therapy on the breast parenchymal pattern. MATERIAL AND METHODS: Screen-film mammographs of 754 women (mean age 51.4 years) who had undergone hormonal replacement therapy (estrogen, gestagen; mean duration 2.4 years) were compared with findings in 206 women who had not received hormonal replacement therapy (mean age 52.3 years). Mastopathic changes were analyzed according to a 4-grade scale and the incidence of circumscribed lesions (such as fibroadenomas, cysts and malignancies) was further evaluated. RESULTS: In the treated women we found moderate mastopathic changes in 47.2%, intermediate changes in 2.4%, and extensive proliferations in 0.7%. For the untreated women the corresponding figures were 33.5%, 4.8%, and 1.4%. In the treated patients fibroadenomas were apparent in 3.9%, cystic lesions in 3.3%, and malignant lesions in 1.4%. In the untreated women fibroadenomas were evident in 11.6%, cystic lesions in 7.2%, and malignant lesions in 2.4%. CONCLUSION: Mastopathic changes might increase under hormonal replacement therapy. However, the higher incidence of circumscribed lesions in the untreated women might be due to the higher number of symptomatic women who sought examination. We also speculate as to whether the increased density of the breast parenchyma in the treated women might cause a higher number of mammographically undedectable lesions.

Breast↗
PubMed1996

Power Doppler versus color Doppler imaging in renal allograft evaluation.

The purpose of this study was to evaluate the impact of PDS compared to conventional CDI in the followup of 72 renal allograft patients. Renal allograft vascularization, assessed by PDS and CDI, was scored from 0 to 4, where 0 was the cortical "blush" and 4 was residual central perfusion. These scores were correlated with the resistive index, serum creatinine levels, hematocrit, and, in 35 cases, biopsy results. PDS scores of renal perfusion were one grade lower than CDI scores in 59 of 72 patients and two grades lower in two of 72 patients. A statistically significant correlation was found between PDS scores and the RI (r2 = 0.6, P < 0.05). However, no significant correlation was found between PDS scores and creatinine levels or hematocrit values. PDS scores are not related to histologic findings in renal allograft dysfunction. Overall, five biopsy-related arteriovenous fistulas were detected, two of which were missed on the initial PDS examination. In conclusion, PDS provides more complete visualization of the renal allograft vessel tree than CDI. However, biopsy-related arteriovenous fistulas are better seen by CDI.

Biopsy↗
PubMed1996

Update on imaging techniques of the wrist and hand.

Several imaging techniques are available and necessary for evaluation and treatment of hand and wrist pathology. Conventional radiography is still the imaging technique of first choice for evaluation of abnormalities of the wrist and hand. Bone scintigraphy is an important diagnostic tool with a high sensitivity but low specificity. Arthrography should be performed if abnormality of ligamentous or triangular fibrocartilaginous pathology is suspected; however, using arthrography, all three major compartments and both wrists should be examined arthrographically. In selected cases, such as occult fractures, fracture healing, and early detection of avascular necrosis, advanced imaging techniques, such as magnetic resonance imaging and computed tomography, may be necessary and are helpful to achieve correct diagnosis.

Arthrography↗
PubMed1996

Five phase bone scintigraphy supports the pathophysiological concept of a subclinical inflammatory process in reflex sympathetic dystrophy.

This study evaluates quantitative and qualitative patterns of bone scintigraphy and correlates them to laboratory findings and clinical signs to reveal possible inflammatory reactions in RSD. Activity ratios between the affected hand/foot and the contralateral side were calculated in 99mTc DPD-bone scintigraphy for five phases (arterial: 0-30 sec, early blood pool: 0.5-5 min. late blood pool: 5-15 min, 3 hrs early bone, 24 hrs late bone phase) and the presence of five scintigraphic signs in the bone phases was assessed. Activity ratios of all phases correlated with ESR those in the early and late bone phase correlated with alpha 2 globulin and beta globulin concentrations and those in the arterial, the early and late blood pool phase with the gamma globulin concentrations, respectively. Clinical features such as pain, swelling, physical force, temperature differences and the duration of symptoms did not correlate to the activity ratios. However, three signs in the bone phase were negatively correlated to albumin concentrations. Positive correlations were found for alpha 2, gamma globulin concentrations, ESR, neutrophil cell counts and individual uptake patterns. We conclude that the quantitative analysis of five phase bone scintigraphy in RSD reveals different aspects of tracer kinetics and provides different pathophysiological information. Lateralization of regional hyperemia, increased micro vascular permeability and bone metabolism in RSD parallels shifts in protein concentrations and blood cell counts that are suggestive of a subacute inflammatory process, even in patients with no overt signs of inflammation.

Beta-Globulins↗
PubMed1996

Randomized comparison of sitting and prone positions for stereotactic fine-needle aspiration breast biopsy.

In a prospective randomized study, 103 women had stereotactic biopsies performed either in the prone (n = 51) or sitting (n = 52) position. Questionnaires were administered before and after biopsy, to measure anxiety, pain and subjective experience in all patients. Vasovagal reactions were scored from 0 to 2 according to severity. There was no significant difference between biopsies performed in the sitting or the prone position with regard to overall tolerance. Significantly more patients biopsied in the prone position (15 of 51, 29 per cent) than in the sitting position (seven of 52, 13 per cent) would prefer premedication before a repeat biopsy (P = 0.04). Of the total patient group, three women fainted, one in the prone position and two others in the sitting position. Breast biopsies performed in the prone or sitting position are equally well tolerated. Somatic reactions such as fainting are not a major problem during breast biopsy; however, attention should be focused on patient care, including information given before the procedure.

Anxiety↗
PubMed1994

[Imaging in parotid tumors: US versus MRT].

27 patients, clinically suspected of having parotid tumours, were examined prospectively by sonography (high frequency linear array) and MRI (1.5 T, T1- and T2-weighted SE sequences before, and T1-weighted SE sequences after contrast). In 23 patients, 25 intraglandular tumours were demonstrated (two were multicentric); they consisted of 6 malignant parotid tumours, 11 pleomorphic adenomas, 7 cystadenolymphomas and one oncocytic adenoma. 4 patients had extraglandular tumours. All tumours were demonstrated by either method, but two extraglandular tumours were incorrectly diagnosed by sonography as being intraglandular and 8 tumours (28%) were not completely delineated by sonography. MRI localised the tumours correctly in all cases and demonstrated all lesions accurately, independent of their position or size. In summary, sonography appears suitable as the primary imaging method in the investigation of parotid tumours but in case of large, parapharyngeal or malignant tumours, MRI is clearly superior to sonography.

Adolescent↗