Biomedical subjects

I Tossounidis

Publications and source records attributed to I Tossounidis.

8 recordsLinked to original sources

PubMed2001

The clinical significance of antenatal pathological Doppler findings in the fetal middle cerebral artery in cases with peripheral reduced diastolic doppler flow but no absence of end-diastolic flow in the umbilical artery or fetal aorta.

PURPOSE: The effects of antepartum pathological Doppler findings in the fetal middle cerebral artery in cases with simultaneously peripheral reduced diastolic Doppler flow on perinatal outcome and the odds ratio of perinatal risks were studied. METHODS: 214 patients were examined by color Doppler ultrasound in relationship to complications in gestation and labor and fetal outcome. One thousand and seventy Doppler flow measurements of the middle cerebral artery, the umbilical artery and the fetal aorta between 28 and 40 weeks of gestation were performed. Sensitivity and odds ratio of synchronous cerebral pathological and peripheral pathological Doppler blood flow with regard to the prediction of intrauterine growth retardation, rate of cesarean section, preterm delivery and newborn depression was calculated. In all Doppler measurements there were no cases with absence of end-diastolic flow. RESULTS: Preterm delivery rate and intrauterine growth retardation rate were significantly higher in cases of synchronous cerebral pathological and peripheral pathological Doppler blood flow as in cases of isolated reduced peripheral blood flow (p<0.001; odds ratio 13.2 and 16.6). CONCLUSION: Pregnancies with no absence of end-diastolic flow in the fetal aorta or umbilical artery, but with reduced diastolic flow in these vessels and simultaneous pathological Doppler findings in the fetal middle cerebral artery are high risk pregnancies, above all in respect to intrauterine growth retardation, preterm delivery and newborn depression. Surveillance of pregnant women should be performed in a perinatal centre.

Aorta↗

PubMed2000

Reference ranges and standard percentile-curves for the Doppler indices RI and S/D ratio of the fetal middle cerebral artery. Color Doppler measurements in a perinatal centre.

PURPOSE: To perform reference ranges and standard percentile-curves for the Doppler indices resistance index (RI) and systolic/diastolic (S/D) ratio of the fetal middle cerebral artery, periodical color doppler sonographic measurements of 70 pregnant women in the 3rd trimester of pregnancy were done. METHODS: 600 Doppler flow measurements of the fetal middle cerebral artery between 28 and 40 weeks of gestation were performed. The patients had no previous obstetric complications, no apparent medical problems and no complications in pregnancy and labor. Percentiles curves were performed for the RI and the S/D ratio from the 10th percentile up to the 90th percentile. RESULTS: In the 3rd trimester of pregnancy fetal cerebral circulation shows an increase of the diastolic component and simultaneous decrease in cerebral resistance. The average S/D ratio in week 29 is 8.0, in week 34 6.0 and in the 40th week 3.5. The RI decrement is from 0.88 to 0.67. Other groups demonstrated similar ranges however absolute data are different. CONCLUSION: The increase in the diastolic component in the middle cerebral artery of the last third of the pregnancy demands reference ranges by using percentile curves. Knowledge of the reference range helps to discriminate between a normal fetal situation and disease. Because of different absolute ranges in the literature each perinatal centre should develop their own data.

Adolescent↗

PubMed1998

Validity of the minimal resistance index for discrimination between benign and malignant breast tumours.

We investigated the validity of the flow parameter minimal resistance index (min RI) for discrimination of breast tumours. Colour and spectral Doppler sonography was performed on 114 patients. An increase in number of tumour vessels was paralleled by a significant drop of the minimal (min) RI (p=0.004) and increase of the maximal (max) RI (p=0.03) while mean RI was not influenced. The present results question the validity of min RI as parameter for discrimination of breast tumours. Min RI does not represent the actual flow resistance.

Breast Diseases↗

PubMed1998

[Diagnostic and prognostic value of vascular resistance in breast tumors].

AIM AND METHOD: In a prospective study of 113 patients with breast tumours, we measured the vascular resistance index (mean RI) of physiologic tissue and the tumour by using pulsed colour coded Doppler sonography. RESULTS: The group of carcinomas showed a significantly higher mean RI (0.71 +/- 0.09 SD) compared to the group of benign tumours (0.66 +/- 0.09 SD) (p = 0.003). After dividing the groups according to menopausal status, this difference disappeared. In general the mean RI was higher in postmenopausal women. Only premenopausal women showed a significantly higher mean RI within the carcinoma (0.69 +/- 0.1 SD) compared to physiological tissue (0.65 +/- 0.07 SD, p = 0.02). The mean RI measured in the tumour area from carcinomas correlated with the S-phase fraction: r = -0.53 (p = 0.003). CONCLUSION: Mean RI reflects vascular resistance but does not allow discrimination between benign or malignant and is significantly influenced by menopausal status. The dynamics of proliferation and low vascular resistance seem to depend on each other. All these facts should be considered when doing Doppler sonographic examination of the breast.

Adult↗

PubMed1997

[Standardized interfaces in gynecologic-obstetric documentation].

Since the introduction of the German GSG-law the usage of software for data recording in clinical departments has substantially grown. These systems should be able to exchange or replicate data, but in most cases the corresponding interfaces are absent or only incompletely implemented. The existence of functional, system-independent interfaces in a CSV-or HL-7-compatible format is a minimal requirement for modern software and should be considered.

Data Collection↗

PubMed1997

[Urodynamic parameters and continence after radical Wertheim-Meigs-Okabayashi hysterectomy].

The aim of this study was to analyse the effects of radical hysterectomy on urodynamic parameters (urethral resistance, functional urethral length, pressure gradients, bladder capacity, residual urine volume, stress urethral pressure profile), on bladder function (detrusor pressure, urgency sensation, flow pattern) and on continence. We reviewed 33 patients who underwent a radical abdominal hysterectomy as described by Wertheim-Meigs-Okabayashi. They were investigated by urodynamic examination preoperatively and 4 resp. 8 months postoperatively. To ascertain bladder dysfunctions and changes of urinary continence as a long term effect of operative procedure a standardized questionnaire was mailed to all patients. The radical abdominal hysterectomy did not alter significantly the urethral resistance, functional urethral length or pressure gradients. The maximal bladder capacity decreased postoperatively from 615 ml to 503 ml (SD 148.5: p = 0.04). The maximal urine flow and the detrusor pressure decreased temporarily (p = 0.01). The residual urinary increased five-fold (p = 0.01) and the first sensation of bladder filling was recognized later, at 4 as at 8 months postoperatively (p = 0.07). Preoperatively 75% of the patients voided by detrusor activity, postoperatively only 16%. 20% of the preoperative continent patients were incontinent during the second measurement (8 months postoperatively). 47% of the previous continent patients complained about incontinence in the questionnaire (4 years postoperatively). Although the patients complained about pollakiuria, urgency (60%) and urge incontinence (39%), 73% of the patients were content with their situation. Although the urethral pressure profile showed no significant alteration, the clinical situation and the deterioration of the parameters bladder capacity, residual urine and flow pattern verified the postoperative disturbances of the lower urinary tract function and the negative effects on continence behaviour.

Adult↗

PubMed1995

[Diagnostic value of color Doppler ultrasound in breast tumors].

The aim of this study was the validation of the minimal Resistance Index (min RI) measured by colour Doppler sonography as parameter of tumour neoangiogenesis. 107 patients with clinically or radiologically diagnosed breast tumour with a sonographically detectable lump had preoperative measurements and analysis of blood flow in the tumour area and in the healthy parenchyma of both breasts. The min RI was compared with histology, menopausal status and age. In all 107 patients blood flow could be measured in the tumour area and in 98% of the bilaterally investigated quadrants. Irrespective of tumour status the mean min RI was lower in the tumour area (0.62) than in the other quadrants of the affected (RI = 0.65, p = 0.002) or contralateral breast (RI = 0.65, p = 0.0003). The mean min RI of benign tumours was 0.60 (+/- 0.11 SD) and of malignant tumours 0.64 (+/- 0.11 SD), this difference was not significant (p = 0.07). Irrespective of tumour status postmenopausal patients had a higher mean min RI than premenopausal patients. This was true for the tumour area (RI = 0.64 vs 0.60, p = 0.11) and also for the quadrants (RI = 0.68 vs 0.62, p = 0.0002). In postmenopausal women there was a statistically significant correlation with age (r = 0.58, p = 0.0001). We conclude that the min RI is of no diagnostic relevance for the classification of breast tumours as benign or malignant.

Adult↗

PubMed1995

[Comparison of different methods for determination of proliferative activity of breast carcinomas].

OBJECTIVES: Different methods for evaluation of nuclear atypia and proliferative activity were compared in fifty cases of breast cancer. METHODS: Beneath histopathologic grading, ploidy of the stem cell line and S-phasefraction were measured by flow cytometry. Ki67-index was determined immunohistochemically and by image cytometry on smears grade of malignancy and 2cDI were measured. RESULTS: Only Ki67-index was correlated with histopathological grading. The various proliferative indices (Ki67-index, S-phase-fraction, 2cDI) were not correlated. Between image- and flow-cytometric DNA-analysis significant differences were found. CONCLUSIONS: With the immunohistochemical determination of Ki67-index in conjunction with image-cytometry a morphologic control of the material investigated is possible. So in comparison with flow-cytometry a more differentiated analysis can be performed.

Biomarkers, Tumor↗