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F Degenhardt

Publications and source records attributed to F Degenhardt.

At least 19 recordsLinked to original sources
PubMed2005

[Interventional methods in diagnostics of the breast -- a new vacuum biopsy system for the breast in routine clinical practice].

AIM: To evaluate the diagnostic potential of the new vacuum-assisted method VacuFlash (VF) in clinical routine of breast diagnostics. METHOD: From april 2002 to march 2003, the new sonographically guided vacuum-assisted system VacuFlash was used in 75 patients with a BI-RADS 5 lesion (analogue). The patients were aged between 31-75 yrs (median: 51 yrs), the size of the lesions measured 8-33 mm (median: 14 mm). 5 specimens were taken from each lesion. RESULTS: In 69 of the 75 lesions (92 %, respectively), malignancy was confirmed. In 8 lesions (8 %, resp.), we found a benign histology, confirmed by consecutive surgery. CONCLUSION: The new vacuum-assisted device VacuFlash is a technically perfected and applicable diagnostic method. Especially in the view of the cost it has to be compared with high-speed core cut biopsy, the hand-held Mammotome system and open surgical biopsy. High-speed core cut biopsy seems to be the standard procedure in diagnostic percutaneous breast intervention to clarify sonographically detected breast lesions.

Adult↗
PubMed1999

[Changes in insulin-glucose quotients in a glucose tolerance test in the third trimester].

OBJECTIVE: In comparison a higher insulin-glucose-index is usually associated with an increased insulin resistance. In the present study changes in insulin-glucose-indices were examined in relation to a defined glucose tolerance in the last trimester of pregnancy. MATERIAL AND METHODS: 249 pregnant women were challenged with a 75 gm oral glucose tolerance test (oGTT). Serum samples for glucose (glucose-dehydrogenase-method) and insulin measurements (RIA) were drawn before and at 30, 60, 120, and 180 minutes after glucose load during oGTT. Patients were assigned to five groups with increasing glucose intolerance according to maximal glucose levels during the test. RESULTS: There were no significant differences in insulin-glucose-indices prior to glucose load. Pregnant women with gestational diabetes were shown to have significantly lower insulin-glucose-indices in the early and intermediate phase of the challenge test while the indices were higher in the final phase of the test. CONCLUSIONS: Women with gestational diabetes demonstrated an initial delay in insulin secretion in combination with a higher insulin-glucose-index, corresponding to an increased insulin resistance, only in the end of the test. These characteristics may possibly be a cause of the observed disorder in glucose metabolism in these patients.

Blood Glucose↗
PubMed1999

[Glutamic acid decarboxylase autoantibody concentration and glucose tolerance in late pregnancy].

Genetic and immunological factors may play a role as possible causes for gestational diabetes. Autoantibodies to glutamic acid decarboxylase (GADA) are frequently found in patients with insulin dependent diabetes, but have only rarely been analyzed with regard to the carbohydrate tolerance in pregnancy. An oral glucose tolerance test (oGTT) with 75 g glucose was performed in 110 pregnant patients during the third trimenon. Glucose (glucose dehydrogenase method) and insulin (RIA) concentrations were measured after 0, 30, 60, 120, and 180 minutes. Patients were divided into five groups of increasing glucose intolerance based on the highest glucose concentration reached during the oGTT. GADA were measured using a quantitative enzyme-immunoassay. Only a single patient showed pathologically elevated GADA, and her oGTT results were within the normal range. GADA in subjects with normal pathological glucose tolerance showed no significant difference (276.6 +/- 151.6 and 263.0 +/- 107.1 mU/ml respectively). There was a tendency of positive correlations between high GADA-levels and higher concentrations of insulin as well as an increased insulin-glucose-index. These findings suggest that pregnant patients with higher GADA-levels may have an increased insulin resistance. In conclusion, the concentration of GADA was not found to be helpful in evaluating the current metabolic situation in gestational diabetes. It remains unclear whether elevated GADA during pregnancy have a prognostic value regarding the manifestation of overt diabetes mellitus later in life.

Adult↗
PubMed1997

Acute abdomen due to endometriosis as a diagnostic and therapeutic challenge in the treatment of acute myelocytic leukemia.

Acute abdominal pain is a frequent diagnostic and therapeutic challenge in hematologic patients. We report on the very rare case of organ endometriosis with acute abdominal symptoms in a 43-year-old female patient with AML-M5, starting 4 days after induction chemotherapy with idarubicin, ara-C, and etoposide. The patient presented with an acute abdomen with clinical findings of acute cholecystitis, subileus, and local pain in the right upper abdomen accompanied by severe diarrhea. Probably due to impaired intestinal resorption, menstrual bleeding occurred despite regular administration of lynestrenol. Ultrasound examination of the abdomen disclosed a tumor with poor echoes in the pouch of Douglas, a subcapsular splenic hemorrhage, and a thickened gallbladder wall with surrounding edema. A cystic adnex tumor was confirmed by endovaginal ultrasound. Based on history and the findings on ultrasound, an endometriosis was diagnosed, and the LHRH agonist (nafarelin) was administered nasally in combination with lynestrenol. Following this medication the abdominal pain ceased, supporting the diagnosis of endometriosis. Nasal administration of an LHRH agonist in the following cycles of chemotherapy was effective in preventing further abdominal discomfort and vaginal bleeding. LHRH agonists should be given to patients with known endometriosis before starting myeloablative chemotherapy to prevent painful hemorrhage from endometriosis.

Abdomen, Acute↗
PubMed1995

[Ultrasound studies in afterloading therapy of uterine malignancy].

The afterloading technique for radiation therapy of gynaecologic malignancies has significant advantages for the patients as well as the medical staff: a reduced risk of perforating the uterus, more accurate treatment planning, a more agreeable treatment environment for the patients and, most importantly, a significant reduction of radiation exposure for the medical staff. Using simple ultrasound methods, the localisation and the extent of the tumour to be treated by radiation therapy can be assessed. With these data, the suitable isodose curves are selected. The distance to adjacent organs, especially of the loops of bowel next to the uterus which are normally not reached by dosimetric probes, can be estimated and the information included into treatment planning, thus reducing the risk of radiation side effects. Furthermore, the insertion of afterloading applicators and dosimetric probes can be checked by ultrasound making injury to the uterus and other organs less likely. At the same time, the correct position of the instruments is verified. For the ultrasonographic evaluation of the radiation response of primarily irradiated carcinomas more data are needed.

Brachytherapy↗
PubMed1995

[Ultrasound morphologic parameters of female stress incontinence].

AIM: The study compared ultrasound parameters of the lower urinary tract with patients' age, number of previous pregnancies as well as the grade of incontinence. Furthermore, the influence of postural changes was studied. METHOD: Ultrasonographic examination of the vaginal introitus was performed on 222 patients using a 5 MHz scanner. The transducer was inserted along the body axis and a vertical plane was defined. RESULTS: Urinary stress incontinence was found to be associated with the occurrence of cystoceles, the finding of a funnel-like opening of the proximal urethra, an increased retrovesical angle beta, and finally with a descent of the bladder neck. However, there was no significant correlation between urethral length and the grade of stress incontinence. In patients without urinary incontinence, the retrovesical angle as well as the position of the bladder neck were strongly related to parity but did not correlate with the patients' age. There was no significant difference between parameters when the patients were straining in a prone or half-prone position. CONCLUSION: Sonomorphological pelvic floor disorder is based on previous pregnancies and correlates well with urinary stress incontinence.

Adult↗
PubMed1995

[Postpartum ultrasound morphology of the pelvic floor].

METHODS: Introital sonography was performed on 131 patients between the first and 13th day (average 4.2 days) after delivery. 41 non-pregnant nulliparous women without any complaints of urinary incontinence served as controls. Post-partum morphological changes were analysed using a 5-MHz vaginal scanner and correlated with parity and mode of delivery. RESULTS: The occurrence of cystoceles and opening of the proximal urethra were strongly related with parity and mode of delivery being more common in multiparous women after vaginal deliveries than after caesarean sections. In the control group, the urethrovesical angle beta was 96 degrees in rest and 102 degrees when straining. After vaginal deliveries, a significantly larger angle was observed when compared to patients after caesarean section. During straining, the bladder neck shortened from 21.4 mm to 13.1 mm compared to -0.7 mm after vaginal delivery. CONCLUSION: Morphological changes of the lower urinary tract after delivery are common. The sonographic appearance of these changes is almost identical to those observed in patients with urinary stress incontinence.

Adolescent↗
PubMed1994

[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↗
PubMed1993

[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↗
PubMed1993

[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↗
PubMed1992

[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↗
PubMed1991

[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↗
PubMed1991

[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↗