Search PubMed⌕ Search

Biomedical subjects

W Eiermann

Publications and source records attributed to W Eiermann.

At least 55 records · Page 3Linked to original sources
PubMed1989

MR imaging of the breast with Gd-DTPA: use and limitations.

Between August 1985 and November 1987, 150 patients with 167 biopsy-proved lesions were examined with magnetic resonance (MR) imaging enhanced with gadolinium diethylenetriaminepentaacetic acid, mammography, and palpation. Of these patients, 113 with 123 lesions were also examined with ultrasound. Enhancement above 300 normalized units (NU) on MR images was considered significant; between 250 and 300 NU, borderline; and below 250, nonsignificant. All 27 fibroadenomas and 70 of 71 carcinomas showed significant enhancement; one carcinoma showed borderline enhancement. Nonproliferative dysplasia showed nonsignificant enhancement in 15 of 16 cases and significant enhancement in one, whereas proliferative dysplasia showed usually diffuse enhancement varying from nonsignificant (five of 30 cases) to borderline (five of 30 cases) to significant (20 of 30 cases). In the nonblind evaluation of the modalities, MR imaging compared favorably. When limitations of the technique were considered, MR imaging seemed beneficial as a supplement in selected, diagnostically difficult cases.

Adenofibroma↗
PubMed1989

Goserelin, a depot gonadotrophin-releasing hormone agonist in the treatment of premenopausal patients with metastatic breast cancer. German Zoladex Trial Group.

One hundred thirty-four pre- and perimenopausal patients presenting with metastatic breast cancer (median age, 42 years; range, 25 to 55) were treated with goserelin (Zoladex [ICI 118 630]; ICI Pharma, Plankstadt, Germany) a long-acting gonadotrophin-releasing hormone (GnRH)-analogue depot formulation, injected subcutaneously every 4 weeks, as a first-line therapy. One hundred eighteen patients were evaluable for response. Serum concentrations of estradiol, luteinizing hormones (LH), and follicle-stimulating hormones were significantly suppressed by Zoladex. Mean serum estradiol values fell into the range of castrated or postmenopausal women within 2 to 3 weeks of therapy. This suppression was maintained for the duration of therapy. Overall objective response was: 12 (10.2%) complete remission; 41 (34.7%) partial remission; 33 (28.0%) no change; and 32 (27.1%) progression. In responders, the median time to response was 4 months (range, 2 to 11 months), median duration of response was 8 + months (range 2 to 24 months), and median time to progression was 11 + months (range, 5 to 30 months). Objective responses were seen for different sites of metastases: loco-regional (62.5%), bone (46.7%), visceral (45.0%), and multiple (35.1%). Tumor remission was more common in patients in which the primary tumor was estrogen receptor (ER)-positive (49.3%) or ER-unknown (44.0%), but appreciable response rates were also observed in ER-poor patients (33.3%). Zoladex depot was well tolerated both locally and systemically. It produced effective castration and the objective response rates and duration of remission are at least comparable to those seen following oophorectomy; however, the side effects are less. The use of depot Zoladex avoids the psychological trauma and operative morbidity of the irreversible operative castration.

Adult↗
PubMed1989

[Computer-assisted tissue analysis for cancer detection in breast ultrasound--significance of reference values].

Due to the inhomogeneous and very variable structure of healthy tissue of the female breast it is often very difficult to detect a carcinoma via computer-aided sonography. The present study based on preoperative measurements in 29 woman patients with carcinoma of the breast aimed at finding out to what extent it would be possible to circumvent this problem by means of additional reference measurements in healthy tissue. For this purpose, relative image parameters were determined besides absolute ones from measurements in tumorous and healthy reference tissue. These relative image parameters are much more suitable for subsequent decision analysis on account of their narrower range of variation. The results obtained in this manner could be improved further by additional optimization or extension (such as analysis of other combinations of parameters, by enlarging the field of measurement and hence the data available per tissue sample, use of higher or even different ultrasound frequencies).

Adipose Tissue↗
PubMed1988

[Serum CA 125 values and histologic findings at the time of second-look laparotomy in ovarian cancer].

In a prospective study CA 125 serum levels of 99 patients with ovarian cancer were determined serially. 50 of 55 patients with second-look-laparotomy elevated levels initially had. We were interested in particular in the correlation between CA 125 and the histological findings at second-look operation. In 16 patients there was no residual tumor, CA 125 was in the normal range. In 34 the women tumor tissue was demonstrated; CA 125 was elevated in 14 patients, so there were 20 patients with false negative CA 125 serum levels. No false positive CA 125 values were found. In all patients with elevated tumor marker the residual tumor was histologically confirmed at second look. To verify a complete remission, a second-look operation will have to be performed in spite of a negative tumor marker, since active tumor tissue might still be present. In patients with elevated CA 125 a second-look laparotomy should be avoided at this time.

Antigens, Neoplasm↗
PubMed1988

[Hormone receptor determination in breast cancer using the dextran- coated charcoal method and monoclonal antibodies: correlation with cytomorphologic grading].

In 129 cases, results from ER-ICA (Estrogen receptor immunocytochemical assay) applied to breast carcinoma biopsy smears and results from ER-EIA (Estrogen receptor enzyme immunoassay) applied to cytosols of breast carcinoma were compared to the results of ER(DCC), PR(DCC) and a cytomorphological grading. Using 500x magnification, the cases were graded visually in 7 groups, groups 1-4 without and groups 5-7 with nucleoli. Cases with high estrogen receptor values as determined by ER-EIA had the best chance of being detected also by the ER-ICA method. There is a relation between the visual nuclear grade from the Pappenheim stained specimens and ER-ICA and ER-EIA. The 48 cases without nucleoli had a mean ER-EIA-value of 100 fmol/mg (median = 59 fmol/mg). The 57 cases with nucleoli (groups 5-7) had a mean ER-EIA value of 37 fmol/mg (median = 14 fmol/mg). For 28 cases with prominent or multiple prominent nucleoli (groups 6-7) the mean ER-EIA value was only 15 fmol/mg (median = 5 fmol/mg). With increasing ER-EIA values we found decreasing average nuclear grades: 31 cases ER-EIA less than 10 fmol/mg, mean nuclear grade = 5.4; 34 cases ER-EIA greater than or equal to 10 less than 50 fmol/mg, mean nuclear grade = 4.6; 20 cases ER-EIA greater than or equal to 50 less than 100 fmol/mg, mean nuclear grade = 4.2; 19 cases ER-EIA greater than or equal to 100 fmol/mg, mean nuclear grade = 3.8. Our present data show clearly that there is a closer correlation of cytomorphology with ER-EIA than with ER(DCC) and PR(DCC). In the present study even ER-EIA alone correlated better with morphology than ER(DCC) and PR(DCC) taken together.

Antibodies, Monoclonal↗
PubMed1988

[Changes in the serum level of female sex hormones following radiocastration using different total doses].

We determined serum levels of estradiol, FSH and LH over a period of six to eight weeks after ovarian irradiation for castration with different doses (2 x 2.5 Gy/3 x 2.5 Gy/4 x 2.5 Gy) in 15 patients with metastatic breast cancer as compared to changes after ovariectomy in five patients. The time course of the changing estradiol-, FSH and LH-serum levels significantly depends on the ovarian dose. After radiological castration with a dose of 4 x 2.5 Gy = 10 Gy in four days the estrogen levels decrease within two to three weeks, and the FSH- and LH-levels increase after three to four weeks into the postmenopausal range. Therefore, the time course is not very different from changes after ovariectomy.

Adult↗
PubMed1988

[Prognostic factors in the indication for labor induction after previous delivery by cesarean section].

The relative importance of prognostic factors in the management of delivery after caesarean section was investigated retrospectively in 300 patients who gave birth between January 1984 and April 1986. Important factors included the parity of the patient (p less than 0.0001), the number of previous caesareans (p less than 0.001), the Bishop's Score on admission (p less than 0.005) and the indication for the previous caesarean section (p less than 0.05). On our series gestational age (p = 0.042) and estimated birthweight (n.s.) were only marginally statistically significant.

Birth Weight↗
PubMed1988

[Dynamic contrast medium studies with flash sequences in nuclear magnetic resonance tomography of the breast].

In this study the dynamic contrast behavior after Gd-DTPA of different breast tissues and tumors has been investigated with a series of T1-weighted FLASH-sequences during the first 5 minutes after the application of Gd-DTPA. The results of these dynamic FLASH-measurements have been compared to the results of the SE-sequences 6-10 and 11-15 minutes after Gd-DTPA in 40 patients with 54 different breast tissues. It could be shown that in a number of cases a better differentiation (e.g. DD between carcinomas and proliferative dysplasia) was possible on FLASH-scans early after contrast medium than on the late SE-scans. Only the distinction between non-proliferative and proliferative dysplasia was better on the late SE-scans. Evaluation of the enhancement dynamics may be helpful in some cases as an additional information. Further investigations are necessary to confirm these findings and to assess their value.

Breast↗
PubMed1987

CA-125 in gynecological malignancies.

CA-125 is an antigenic determinant that can be demonstrated in the majority of epithelial ovarian carcinomas. It can be measured in the serum with a radioimmunoassay by means of a monoclonal antibody. The tumor marker has a low specificity but high sensitivity for ovarian cancer, especially for serous cystadenocarcinoma. In our investigation we were interested in particular in the correlation between CA-125 and the histological findings at second-look operation. In 22 patients, second-look was performed after 6 cycles of chemotherapy, in 16 patients active tumor was demonstrated. In 6 patients with negative CA-125 values, residual tumor less than 1 cm was demonstrated. In order to verify a complete remission, a second-look operation has to be performed. No false-positive CA-125 levels were found. In all patients with elevated CA-125 serum values, residual tumor was histologically confirmed at second look.

Antigens, Neoplasm↗
PubMed1987

[Contrast enhancement of the nipple in nuclear magnetic resonance tomography of the breast with Gd-DTPA].

Contrast enhancement around the nipple has been evaluated retrospectively in 51 of 70 patients in respect of the underlying breast disease. 2 of the patients had to be considered separately because of malignant disease of the nipple or areola itself. The remaining 49 patients showed no close relation between the underlying breast disease and the amount of contrast enhancement in the nipple. This phenomenon of a non-pathological significant contrast enhancement of the nipple appears important to avoid false positive diagnoses in MRI of the breast with Gd-DTPA.

Breast↗
PubMed1987

[Radioimmunoscintigraphy with monoclonal antibodies].

Radioimmunoscintigraphy is presented as a new imaging modality in nuclear medicine, using specific antigen-antibody interactions. Monoclonal antibodies to tumor-associated antigens facilitate the characterization of molecular differences between tumors and normal cells. Labelled with gamma-emitting radioisotopes like I-131, I-123, In-111, and Tc99M, these antibodies can be used for in-vivo imaging. Radioimmunoscintigraphy does not compete with morphological modalities like CT and ultrasound, but provides additional information based on its functional principle. Hidden lesions may be detected. Target-to-background ratios, however, are still rather low hampering scintigraphic imaging. The use of Single Photon Emissions Computed Tomography (SPECT) in addition to planar scintigraphy resolves background activities thus providing better visualization and localization of tumors, and increasing sensitivity. The high cost of these time-consuming studies is still a limiting factor to its wider use. Its preliminary indication is founded on the suspicion of tumor progression, based on clinical findings and/or increasing serum tumor markers (CEA, CA 19-9, CA 12-5). This paper provides an overview over possible applications of radioimmunoscintigraphy. Its clinical use is demonstrated by studies of malignant melanoma, colorectal cancer and ovarian cancer.

Antibodies, Monoclonal↗
PubMed1987

Relative binding affinity at metribolone androgenic binding sites of various antiandrogenic agents.

Sebaceous glands are androgen sensitive structures with activity reduced by antiandrogens. We characterized the relative binding affinity of cyproterone acetate, 17 alpha-propyl-mesterolone, spironolactone (canrenoic acid), ethisterone and dexamethasone by means of the competitive binding analysis at metribolone (R1881) androgen binding sites. Using the DCC-assay (dextran-coated charcoal absorption) with the Scatchard plot and saturation analysis we quantified R1881 androgen binding sites from sebaceous glands situated in the ventral side of the pinna of the Syrian hamster. As parameters for ligand affinity at these binding sites served the ligand concentration for 50% displacement of 3H-labelled synthetic steroid R1881 in constant concentrations. The in vitro measurements of the used steroids were compared to the biologic sebosuppressive effect in vivo. 17 alpha-Propylmesterolone showed the highest affinity at the androgenic binding site followed by ethisterone, cyproterone acetate and spironolactone. The results, however, do not admit an interpretation about the mode of action of the given substances, which display their biologic activity either after systemic or topic administration. In vivo distribution problems and metabolizing procedures might be due to this discrepancy.

Androgen Antagonists↗
PubMed1987

MRI of the breast--histopathologic correlation.

132 solid breast masses have been examined at our institution by MR and have consequently been histopathologically correlated. T1- and T2-weighted SE and multi-echo sequences have been evaluated visually. It was found that signal intensities of tissues on T2-weighted images correlated with the contents of fibrosis, cells or water. Thus in some lesions (which consisted of different tissue components), a characteristic internal structure was visible on T2-weighted images, reflecting their histopathologic structure. Corresponding to their different composition, differences of signal intensity have also been noted between those fibroadenomas with a high contents of fibrosis and all other well-circumscribed breast lesions (fibroadenomas, carcinomas). However, for the majority of lesions with irregular contours a discrimination based on signal intensities or calculated T1- and T2-values did not seem possible. This overlap can also be explained by the macroscopically similar composition (amount of fibrosis, water or cells) of benign and malignant irregular lesions.

Breast↗
PubMed1986

[Cytomorphological grading and hormone receptor status in breast carcinoma. Visual studies of smear preparations].

From 923 breast cancers sent in for hormone receptor determination, 745 diagnostically utilizable Pappenheim-stained biopsy smears at 500-fold magnification were classified into eight atypia groups (1-4 without nucleoli, 5-8 with nucleoli) visually in terms of the severity of the cellular malignancy criteria. The hormone receptor status was determined with the dextran-coated charcoal method. Values from 10 fmol/mg estrogen receptor (ER) and (or) progesterone receptor (PR) content were designated as receptor-positive. There was a decrease in the proportion of receptor-positive results with increasing degree of atypia from 97% in group 2 (cases with only small nuclei without nucleoli) to 37% in group 7 (cases with multiple prominent nucleoli). When the average atypia values of subgroups were compared, the highest values were found for the 222 receptor-negative carcinomas. The marginally receptor-positive values were on average between the receptor-negative and the receptor-positive cases with high values. Both the low-ER and the low-PR have more pronounced criteria of malignancy compared to the respective high-receptor reference group.

Biopsy↗