Biomedical subjects

H Madjar

Publications and source records attributed to H Madjar.

10 recordsLinked to original sources

PubMed1992

[The normal vascularization of the female breast in Doppler ultrasound].

Specific Doppler-Ultrasound methods for the differentiation of benign and malignant lesions by measurement of abnormal flow, have been known for more than 10 years. We used this method also in many patients without pathological breast problems and found a high physiological variation of blood flow. As basic definition of normal flow, to be compared with patients under medical treatment of mastopathy, we studied flow variations during menstrual cycles in normal volunteers. In both breasts we measured the amount of vessels, average frequency shifts according to flow velocity and the sum of all Doppler shifts, as measurement of the overall vascularity. Between different individuals the range of Doppler shifts was between 500 and 1000 Hz. However, in individual subjects the variation was only between 50-200 Hz, average 100 Hz. We also found between contralateral breasts no remarkable difference in vascularity. Flow increased at the 10th day after onset of menstruation, in 9 cycles with ovulation and in 8 cycles with a lack of gestagen production. Dramatic flow increase occurred in one early pregnancy. It appears that influences of drugs can be controlled, after basic measurements of individual vascularity.

Adult↗

PubMed1992

[Does color Doppler complement breast examination?].

Improvements in breast cancer detection are underway with work being done on different imaging techniques and the assessment of abnormal vascularity. In an earlier study we used a 10 MHz CW Doppler pencil probe. In palpable carcinomas 94% had shown abnormal vascularity. However, in nonpalpable lesions, this method did not allow flow detection in combination with imaging. Recent developments in color flow mapping allow detection of small tumor vessels, which are invisible on B-mode ultrasound. Registration of vessels simultaneously to B-mode imaging allows this method to be used for nonpalpable lesions. The sensitivity of diverse Doppler instruments shows remarkable differences. This makes uniform evaluation of the method difficult. We examined 94 symptomatic women using different equipment. In 9 of 32 carcinomas no Doppler signals were found. However, CW Doppler showed low vascularity in these 9 false-negative cases. However, the variation of vascularity in malignancies does not yet allow routine application of this method and needs further scientific evaluation.

Breast Neoplasms↗

PubMed1991

Continuous-wave and pulsed Doppler studies of the breast: clinical results and effect of transducer frequency.

Malignant growth requires a high metabolism. This allows the differentiation of lesions by Doppler measurements of their vascularisation. In this study of 224 patients with 45 malignancies (37 breast cancers and 8 local recurrences), 87% of the cases were correctly identified. Differentiation of palpable lesions was possible in 93%. The flow in normal breast arteries was studied as well as in carcinomas, comparing continuous-wave (CW) Doppler with frequencies at 4 and 8 MHz. To improve flow evaluations in nonpalpable lesions, pulsed Doppler was used at 3 MHz and color mapping systems at 5 MHz in another 37 patients. Color Doppler at 5 MHz identified 17 of the 21 malignancies; in all cases pulsed Doppler at 3 MHz failed.

Adenofibroma↗

PubMed1990

[Analysis of a method for Doppler study of the female breast].

Besides characteristic morphological differences, carcinomas of the breast show remarkable changes of vascularity, which are essential for their enhanced metabolism. High-frequency CW Doppler allows to investigate normal and pathological vascularisation in the breast. In our basic study we examined 200 patients, 37 with breast malignancies (6 non-palpable lesions). 33 of the carcinomas showed pathological vascularisation. In an extended examination procedure we investigated also normal breast vascularisation and compared it with blood flow in lesions. We developed therefrom an easy and rational method which allows physiological blood flow measurements as well as a differentiation of breast lesions within a few minutes' time.

Adenofibroma↗

PubMed1990

[Prognosis of triplet pregnancies].

31 triplet pregnancies (DG), treated during 1975-1989, were analysed retrospectively. 13 DG (D10) were registered up to the end of the 10th week of pregnancy, 16 (DG) (D16) were intact between the 11th and the 16th gestational week. 3 DG resulted from the reduction of high grade multiple pregnancies. 18 DG (62%) of the initial 29 DG had previously been treated for sterility. The spontaneous foetal loss (DF) in group D10, including the perinatal mortality, amounted to 26% (10 of 39 DF). In one case of this group, a previously vital DF died. In another case, a partial bi-phasic abortion occurred followed by a premature birth of the surviving 3rd DF. The mortality rate in group D16, including the perinatal mortality (4 DF), was 25% (12 of 48 DF). 30 DG were still intact after the 16th week of pregnancy. 2 DG (7%) suffered from EPH-gestosis. In 4 DG (13%) a foeto-foetal transfusion syndrome occurred. 5 DF (6%) had some of the serious malformations. 27 DG were completed. 7 DG (26%) ended before the 32nd gestational week. In 13 DG (48%), a Caesarean section was performed. The perinatal mortality amounted to 11% (9 of the 81 DF) including all the births from the 25th gestational week upwards. On comparing these results with the data in the literature, a significant improvement in the prognosis of DG in recent years can be observed. This is due to the progress in antenatal and neonatal care.

Cesarean Section↗

PubMed1990

[Differential breast diagnosis using CW-Doppler ultrasound].

There is no method that allows satisfactory differentiation between benign and malignant breast lesions. We were able to differentiate 94% of palpable malignant tumours with CW-doppler ultrasound, which helps to increase the efficiency of clinical examinations, breast sonography and mammography. Two hundred patients were examined with an 8 MHz CW-doppler probe. The symmetry of arterial vessels and flow velocity in normal breasts is very high. Carcinomas appear as areas with localized flow increase. Only in two normal patients was a minimal focus of two arteries found.

Breast Neoplasms↗

PubMed1989

[Assessing the extent of gynecologic tumors by a sonographic tumor score with special reference to ovarian cancer].

Ultrasonic findings in 1317 operatively confirmed gynecological tumors were classified according to five degrees of homogeneity: I, clearly outlined solitary cysts; II, clearly outlined homogeneous tumors; III, poorly defined or slightly heterogeneous tumors; IV, marked heterogeneous tumors; V, completely heterogeneous tumors. In the different groups, the rates of malignancy were: I, 0.9%, II, 1.9%; III, 17%; IV, 58%; and V, 75%. In a further study 1082 patients with a negative or doubtful result of the physical examination were investigated using ultrasound. Abnormal findings in 126 cases were able to detect 8 carcinomas, 25 kystomas, and 63 other tumors.

Female↗

PubMed1989

[The prognosis of sonographically early diagnosed twin pregnancies].

We retrospectively analyzed 95 intact twin pregnancies (GG) only diagnosed by sonography during the period 1977-1987: 48 GG were registered up to the 10th week of pregnancy (G 10), 90 between the 11th and the 16th week of pregnancy inclusive (G 16). In the group G 10, this spontaneous fetal loss, including the perinatal mortality amounted to 10.9% (10 of 92) twins (GF). In 5 cases from this group, a previously vital twin was lost before the 10th week. The loss in group G 16, including the perinatal mortality, was 9.7% (17 of 176 twins GF). An early or late abortion occurred in 6 cases (6.8%) and dies perinatally in this group. 82 GG were carried out to full term. 38 women (46.3%) had premature births, 12 pregnancies (12.6%) ended before the 34th week of pregnancy. The perinatal mortality rate amounted to 3.0% (5 GF), 4 (2.3%) of 172 GF had serious malformations. In 6 GG (7.4%) the weight of the twins differed more than 25%.

Female↗

PubMed1986

[Differentiation of breast cancers by Doppler ultrasound].

Breast sonography is a well-accepted diagnostic method. For differentiation between benign and malignant lesions quantified sonography is gaining increased importance. In addition to measurements of velocity, attenuation and elastic properties of tissue, analysis of blood flow by CW Doppler ultrasound plays an important role. Malignancies usually show increased vascularity and extremely disorder. The peripheral resistance is low due to numerous AV-shunts in malignant tissue. With high frequency CW Doppler ultrasound (8-10 MHz) these anatomical and physiological features can be outlined objectively. Frequency analysis of Doppler signals in breast malignancies shows high intensities corresponding to increased blood flow. But also a broadening of the systolic peak with flattening of systolic increase and diastolic decrease as well as high diastolic flow. The different blood flow directions of the vessels recorded by the ultrasonic Doppler beam also cause broadening of the frequency range. In combination with B-mode ultrasound this method provides information essential for the differentiation of malignancies.

Breast Diseases↗

PubMed1986

[Breast sonography with the new water bath scanning technics].

At 1188 patients we investigated the value of sonography of the breast in the detection of malignancies. We used 2 automatic multitransducer water-bath scanners, at first the 3 MH Octoson, then System 1, a dedicated 4 MH water-bath breast scanner which allows for compound and simple scans in any scanning plane. The sensitivity for detection of 63 malignancies was 87%. Other pathologies were 18 fibroadenomas, 160 cysts, 6 abscesses, 2 fatty necroses, 2 papillomas, 9 prostheses, one of them broken. The difficulties associated with differential diagnosis in breast sonography are discussed in detail.

Abscess↗