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Biomedical subjects

Bernd Wagner

Publications and source records attributed to Bernd Wagner.

4 recordsLinked to original sources
PubMed2005

Staging bladder carcinoma by three-dimensional ultrasound rendering.

Organ-confined staging for bladder cancer has major impact on further treatment. Most imaging techniques for this purpose are insufficient. We, therefore, assessed the value and the limitations of a new diagnostic tool, the 3-D ultrasound (US) rendering, to distinguish invasive from noninvasive bladder cancers. A total of 63 patients underwent 3-D US of the bladder before transurethral resection or radical cystectomy. The US findings were compared with the pathologic stages of the transurethral resection material or the cystectomy specimens. Superficial (pTa) carcinomas were correctly staged in 66% by 3-D US. Lamina propria infiltrating (pT1) were correctly staged in 83% and the quota of correct staging of infiltrating carcinomas (>pT1) by 3-D rendering was 100%. The overall accuracy was 79%. Three-dimensional US rendering is most valuable to discriminate between superficial stages pT1. This new technique might improve staging of bladder cancer.

Cystectomy↗
PubMed2003

[Prevalence of osteoporotic fractures in patients treated by androgen blockade for prostate cancer].

INTRODUCTION: Endocrine therapy is the standard first-line treatment for metastatic prostate cancer. The use of this treatment modality for a number of years in a large population has demonstrated some of its iatrogenic complications, especially bone complications. Hypogonadism induced by chemical castration can be responsible for osteoporosis that may be complicated by fractures. OBJECTIVE: Evaluation of the prevalence of fractures in nonmetastatic sites. PATIENTS AND METHOD: Retrospective study of 49 patients treated for more than 5 years by endocrine therapy with determination of the fracture rate, mechanisms and fracture sites. RESULTS: Eight patients developed fractures after antiandrogen treatment. Three patients with a traumatic or metastatic fracture were excluded. Five patients (10.2%) were considered to present osteoporotic fractures on the basis of their site (vertebra and neck of femur) or their mechanism (minor trauma). The mean duration of treatment in these patients was 8.1 years. The prevalence of osteoporotic fractures in the general population is estimated to be 2.2 per 1,000 men between the ages of 65 and 80 years and 6.4 per 1,000 men after the age of 80 years. CONCLUSION: The prevalence of osteoporosis induced by endocrine therapy is increasing due to longer patient survival and early introduction of treatment. No prophylactic treatment is currently proposed when starting endocrine therapy.

Aged↗
PubMed2002

[Retrobulbar irradiation for Graves' ophthalmopathy -- long-term results].

BACKGROUND: Significance of retrobulbar irradiation in patients suffering form Graves' ophthalmopathy, though established since almost one century, is subject of scientific debate. The present study investigated the effect of retrobulbar irradiation using a standardized protocol focussing on long term results. PATIENTS AND METHODS: Between 1981 and 1997, 104 patients treated by retrobulbar irradiation (10 to 20 Gray) due to Graves' disease. Twenty-nine of these underwent irradiation as sole treatment (mean follow-up 57 months), while in the remaining 75, it was combined with a systemic steroid treatment (mean follow-up 40 months). Patients were evaluated regarding proptosis, intraocular pressure, lid signs, motility as well as subjective assessment of double vision and retrobulbar pain. RESULTS: While proptosis remained unchanged, lid signs, chemosis and intraocular pressure showed slight and statistically significant improvement. However, these findings were considered to be clinically insignificant. Retrobulbar pain was improved in 75 % of patients. 25 % of patients showed improved motility, 75 % remained stable, and in none of them was there a deterioration of ductions. Results proved stable even in long-term follow-up. 25 % per cent of patients underwent a surgical procedure one year after radiotherapy. CONCLUSIONS: In our series, we could not demonstrate an additional benefit of systemic steroids when combined with retrobulbar irradiation. Up to sixteen years after treatment, no treatment-related adverse reaction was seen. We found a remarkable improvement in ocular motility. This holds even more true in comparison to the natural course of the condition. Retrobulbar irradiation seems to shorten the duration of the disease, thus allowing earlier performance of eventual rehabilitative surgery.

Adult↗