[Pregnancy and short-wave therapy].
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Biomedical subjects
Publications and source records attributed to R Callies.
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Estrogen deprivation by aromatase inhibition is an effective treatment in breast cancer. Between October 1986 and March 1988, 91 postmenopausal patients with advanced breast cancer entered a phase II study performed jointly in three center to investigate the new aromatase inhibitor 4-hydroxyandrostenedione. Patients received 500 mg 4-hydroxyandrostenedione intramuscularly (IM) every 2 weeks for 6 weeks, and 250 mg every 2 weeks thereafter. There were two complete (CRs) and 19 partial remissions (PRs) (response rate, 23%). Disease stabilization (no change; NC) was seen in 26 patients, and in 44 patients (48%), disease progression occurred. Duration of the CRs is 20+ months, median durations of PR and NC are 13+ and 8 months, respectively. Receptor status, relapse-free interval, and sites of metastatic lesions did not appear to influence treatment results. However, efficacy of previous tamoxifen treatment favorably predicted response to 4-hydroxyandrostenedione. Serum estradiol levels decreased significantly in patients after 2 weeks of treatment. Side effects were mostly nonspecific and of low degree, requiring discontinuation of treatment in only 3% of the patients. We conclude that aromatase inhibition with 4-hydroxyandrostenedione is efficacious in the treatment of postmenopausal breast cancer.
Inpatients with progressive systemic scleroderma were submitted to ultrasound application several times every day. This type of ultrasonic therapy is practicable. Pain decreased in 18 of 24 patients. At the end of therapy, pain had not increased in any of the patients. The strength of the hands was significantly improved in all patients.
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A comparative radiographic and histological study was carried out in 126 patients with malignant and benign breast lesions. Prior to biopsy an additional film- and xeromammogram, both at oblique projection, were taken of each patient. The X-ray film was Definix Medical (Kodak), processed 5.5 minutes. The xerograms were taken with 1.5 mm aluminium total filtration, and developed by negative mode. The X-ray equipment consisted of a Senograph (CGR). The image evaluation was carried out independently by seven observers of varying experience in mammography by means of ROC-analysis. There is no loss of diagnostic information content in negative mode xeromammography, on the contrary, it seems to be slightly superior to film mammography.
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In 1975 John Wolfe proposed a classification of mammographic findings concerning the distribution of the duct pattern to select patients with high cancer risk. In a retrospective study we classified 160 patients with breast cancer according to the duct pattern classification. Our findings support well the results of Wolfe. Type N (normal duct pattern) is found in only 8,9% of all cancer patients whereas breast cancer was combined in 80% with the P2-DY-type. Our investigation confirms the classification of the duct pattern according to Wolfe as a valuable addition to the mammographic diagnosis of breast cancer.
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For the physiotherapy of rheumatic diseases principles of order are recommended. The aims of physiotherapy (allevition of pain, improvement of mobility, inhibition of inflammation), dosages of physiotherapy (intensity of treatment, time of treatment, region of treatment), quantification of pain and reaction to treatment are in the foreground in these cases. With regard to an appropriate choice of methods these principles of order are explained at the instance of the rheumatoid arthritis and the ankylosing spondylitis. Concerning the rheumatism of the soft tissues a classification of the therapy according to localisation and course of the disease (acute, recurrent, chronic) is explained.
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The hitherto given recommendations for physiotherapy in progressive sclerodermia are in most cases undifferentiated. Proceeding from the aims of an influence of sclerodermic changes of the tissues, a prevention of restrictions of the movement and an improvement of the general condition a classification of suitable physiotherapeutic measures is recommended.
The relationship of physiotherapy to psychology, psychotherapy, and psychiatry is critically examined from the point of view of physiotherapy. The relations existing between these disciplines cannot, at present, be considered satisfactory from an overall therapy point of view. The paper also discusses tendencies toward interdisciplinary collaboration.