Biomedical subjects
C Hessler
Publications and source records attributed to C Hessler.
[Large breasts, small breasts; which mammographic technic?].
The variation of dose and image quality parameters in the voltage range 25...33 kV have been studied on 3 mammographic phantoms simulating thin, average and thick breasts respectively. The global image quality has been objectively evaluated by an image quality index. The average glandular dose has been chosen as relevant indicator of risk. The study shows that the surface dose and the midplane dose are not suitable indicators of risk if the breast thickness is variable. For all phantoms, the deterioration of image quality with voltage increase was found to be relatively less important than the decrease of the average glandular dose. Consequently, the following optimum voltages are proposed: 28-29 kV for thin breasts, 29-30 kV for average breasts and 33-35 kV for thick ones. The study showed that breast thickness variation is not suitably compensated by the automatic exposure devices currently available.
Objective assessment of mammography systems. Part I: Method.
The authors have developed an experimental method for simultaneous determination of dose and image parameters in mammography. A global and objective quality concept, the image quality index, is proposed and its reliability demonstrated by tests of reproducibility. Objective quality tests and subjective evaluation by radiologists showed good correlation.
Objective assessment of mammography systems. Part II: Implementation.
A quality control program for mammography units was carried out, based on objective tests of image quality and dose. Results are reported for 31 units, including correlation between various parameters. Satisfactory results were obtained in the case of 21 installations; for the other 10, comparison between measured quality parameters and those of the reference system suggested ways in which quality might be improved.
[Radiologic evaluation of kidney injuries].
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[Gynecomastia. Radiological and pharmacological aspects].
Though frequently unilateral on clinical examination, mammography often reveals the presence of a small impalpable gynecomastia in the contralateral breast. The left breast appears to be the one usually involved, both clinically and radiologically. Gynecomastia is usually iatrogenic in nature, mainly as a result of cardiac stimulants or diuretics, but on rare occasions arises from severe unsuspected organic lesions in the testes, liver, or adrenals, or from endocrine disequilibrium.
[Thermographic modifications of the breast in benign disorders simulating cancer].
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[Subclinical varicocele: detection using Doppler and thermography].
We think that we must find out a varicocele in every case of oligospermia, asthenospermia and teratospermia, particularly with spindle-shaped spermatozoa. If the clinical examination remains negative, it is necessary to provoke a backflow at the Doppler by carrying out a Valsalva's maneuver. If the obtained result is positive, we must then make a high ligature on the left vena spermatica. It seems that the bursae thermography has a prognostic value on the spermogramme's evolution following a subclinical varicocele cure.
[Surgical verification of cholelithiasis, diagnosed previously by ultrasonography].
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[Benign lesions simulating breast cancer].
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Hamartoma of the breast: diagnostic observation of 16 cases.
Of 10,000 mammographies done over a 9-year period, 16 cases of hamartoma of the breast were diagnosed. The entity is a well delimited mass composed of dysplastic-appearing mammary tissue admixed to fat. It can be readily recognized and should not be confused with fibroadenoma or mammary dysplasia. The accuracy with which it can be diagnosed by mammography makes possible the avoidance of surgical excision in selected patients.
[Diagnostic procedures in the evaluation of malignancy degree in breast cancer. Radiological view point].
The value of mammography and thermography for evaluation of breast cancer malignancy is reviewed. The only radiologic finding that changes the prognosis is peritumoral edema, either localized or involving the whole breast; when present, this edema has unfavourable implications for prognosis. Thermography, on the other hand, provides a much better idea of prognosis when the tumor is palpable. In this case the prognosis is influenced much more by the degree of hyperthermia than by the clinical size of the lesion.
[Traumatic paramediastinal air cysts].
A case of double paramediastinal air cyst is described. The diagnosis is easy if the identity is known. Spontaneous regression was always the outcome in the cases published so far. No treatment is necessary. Radiologic examination should include only films of the chest and baryum swallow. The lesion must be recognised in order to avoid unnecessary diagnostic and therapeutic measures.
[Role of infra-red thermography in the diagnosis of breast diseases].
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[Importance and limitations of thermography for diagnosis and treatment of breast diseases (author's transl)].
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[Usefulness of detection of breast cancer: the part played by the internist].
The prognosis of breast cancer is the result of many factors, among which the mass of the tumor at the time of diagnosis remains the most significant: small tumors have a better prognosis than larger ones and are less often accompanied by positive lymph nodes. It is therefore justifiable to search for them systematically by breast examination of all patients over 30. Large-scale mass screening campains in the USA, with clinical and mammographic examination of tens of thousands of women, have proven that it is possible to detect more "early" cancers and reduce general mortality in the groups studied. The number of cancers thus detected is nevertheless so small that it does not justify the investment of so much labour and money in this kind of campaign. Systematic breast examination at regular intervals (6 months to 1 year) with regular mammographies should be confined to patients in the high risk groups: women who have already undergone surgery for cancer of one breast, and patients with a marked family history of breast cancer. For the rest of the female population, the solution seems obvious: every physician should get into the habit of performing regular clinical examination of the breasts. Most gynecologists are already doing so, but they only examine a small part of the population. The most important role in the detection of breast cancer falls to the internists and the general practitioners: they should assume responsibility for all their patients' breasts, in the same manner as they do for heart and lung examinations. They will then request additional examinations (mammography, thermography) as soon as clinical examination reveals a pathological finding. The results of GILBERTSEN [5] confirm that clinical examination remains the most valuable and least expensive method for breast cancer detection.
[Contribution of thermography in exophthalmos].
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