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W Sauerbrei

Publications and source records attributed to W Sauerbrei.

At least 55 records · Page 3Linked to original sources
PubMed1996

Classification of adnexal tumors by transvaginal color Doppler.

The purpose was to evaluate the validity of transvaginal color Doppler sonography for differentiating between benign and malignant ovarian tumors. Color Doppler and Duplex measurements were obtained in 212 (144 benign, 68 malignant) ovarian and tubarian tumors preoperatively. One hundred and thirty-one patients were postmenopausal and 81 premenopausal. An ATL UM9/HDI was used. The following criteria were analyzed: minimum and mean resistance index and pulsatility index, number and distribution of tumor arteries, diastolic notch, and the maximum, minimum, mean, and sum of all peak systolic, maximum enddiastolic, and time-average maximum velocities. Most criteria showed highly significant differences between benign and malignant tumors with variable overlaps. RImin gives a sensitivity of 80%, specificity of 69%, and accuracy of 75% for postmenopausal patients and 80, 59, and 67% for pre- and postmenopausal patients, respectively. PImin gives equivalent results. The number of tumor arteries and the maximum flow velocities increase the accuracy. The summation of all flow velocities gives the best result with a sensitivity of 93%, specificity of 85%, and accuracy of 87% for postmenopausal and 91, 76, and 80% for pre- and postmenopausal tumors, respectively. Flow data show no relevant differences between low malignant potential tumors and ovarian carcinomas. Serous cystadenomas and benign teratomas show higher differences than mucinous cystadenomas, functional cysts, and endometriomas in comparison to malignancies. A separate analysis of pre- and postmenopausal tumors is important. Differentiation seemed better for post- than for premenopausal tumors. The four flow criteria (RImin, number of tumor arteries, and maximum and sum of all peak systolic velocities) seemed appropriate for tumor differentiation. However, this study confirms that a single measurement is not sufficient to differentiate ovarian lesions. Measurements of flow velocities (e.g., maximum and sum of all peak systolic velocities) are superior compared with RImin and PImin.

Blood Flow Velocity↗
PubMed1996

Development and validation of diagnostic scores for atopic dermatitis incorporating criteria of data quality and practical usefulness.

No objective classification criteria for atopic dermatitis (AD) exist. Therefore the diagnosis is usually based on many variables including anamnestic, clinical, and laboratory findings. The aim of this study was to develop and validate a diagnostic score to standardize the diagnosis of atopic skin diathesis for clinical and epidemiological studies. In two separate studies, each consisting of cases and controls, 19 atopic binary features were examined by two independent experienced physicians and these features were classified as "objective," respectively, "subjective." On the basis of these criteria and two additional laboratory measures, we developed a score with high discriminative ability, using the logistic regression model and backward elimination. Ignoring "subjective" variables and the two laboratory measures, two additional models were built that had a worse fit in the original data, but still yielded high estimates of sensitivity (approximately 90%) and specificity (approximately 96%). Using the same data as for the model building, it is well known that these estimates are too optimistic. The validation study allows us to obtain unbiased estimates of sensitivity and specificity for the different scores and to investigate the influence of data quality-here given by the assessment of the reproducibility of the features (objective and subjective)-on the usefulness of diagnostic scores. The results of the validation study show that we developed simple and easy-to-use scores offering a base for a broad practical use in epidemiological and clinical research. In addition, we demonstrate that the criteria classified as "subjective" have no influence on the case-control status in the validation study.

Adolescent↗
PubMed1996

[Combined evaluation of ovarian tumors with transvaginal B-image and color Doppler ultrasound].

Transvaginal sonomorphologie and colour Doppler measurements were obtained preoperatively in 212 adnexal tumours: 81 premenopausal tumours (13 malignant and 68 benign) and 131 postmenopausal tumours (55 vs 76). Tumours were divided into five different scores according to their sonomorphology [16]. Scores I and II are related to benign tumours. Score V represents typically malignant tumours. Scores III and IV are associated with benign and malignant tumours. If score I and II are considered as benign and score III to V as malignant the sensitivity in pre- and postmenopausal tumours is 90%. However, the specificity is only 56% vs 70% respectively. In order to improve the accuracy, colour Doppler was additionally performed in tumours with sonomorphological score III and IV. The following criteria were tested: minimum resistance index (Rlmin), number of tumour arteries (ART), maximum (Smax) and sum (Ssum) of peak systolic velocities. All criteria showed significant differences between benign and malignant tumours. Tumours of score III and IV were differentiated by colour Doppler with an accuracy between 66% and 81% for premenopausal and 69% to 86% for postmenopausal women. The combination of sonomorphology and colour Doppler increased the accuracy between 84% and 90% with a sensitivity of up to 92% in pre- and 89% in postmenopausal patients. Sequential colour Doppler sonography as a supplement to transvaginal sonography improves tumour differentiation. The limitation of colour Doppler measurements to score III and IV lesions reduced the length of examination time to a reasonable extent.

Adolescent↗
PubMed1996

[Champagne administered by spoon for peritonitis after cesarean section. From the history of obstetrics in Erlangen--data from about 60,000 deliveries in 100 years].

The University of Erlangen has been engaged in clinical obstetrics for approximately 170 years. During this time, Erlangen University's delivery house, opened in 1828 and at first having considerably less than 50 births a year, developed into a perinatal centre with approximately 1,700 births a year. For the period from 1880 to 1981, a group of MD students reviewed the existing records and evaluated 60,000 births with respect to more than 40 parameters. Part of the results obtained are shown with special reference to operative obstetrics. Apart from the general influence of the scientific development on decisions and results within obstetrics, individual factors were also recognizable, factors which are linked with the experiences, insights and specialized working areas of the particular head of the hospital.

Cesarean Section↗
PubMed1995

Prognostic value of DNA ploidy and S-phase fraction in stage I endometrial carcinoma.

Both nuclear DNA content and S-phase fraction (SPF) can be helpful in predicting prognosis in certain malignancies. We investigated in a retrospective study the prognostic significance of nuclear DNA content and SPF as measured by flow cytometry of tumor specimens from 162 women with nonpretreated surgically staged FIGO stage I endometrial cancer using clearly defined inclusion criteria. A total of 139 (86%) cases were found to be diploid, whereas 23 (14%) were aneuploid. Ploidy showed a correlation with histologic grade, estrogen as well as progesterone receptor levels, and depth of myometrial infiltration. Univariate analysis of follow-up data showed an increased relative risk (RR) for recurrence-free survival (RFS) for grade 3 tumors (RR = 2.11, ns), for age (RR = 1.04, P = 0.023) as a continuous variable, and for SPF in diploid tumors (RR = 3.10, P = 0.035). In addition, univariate analysis of overall survival revealed similar results with a slightly increased relative risk for ploidy (RR = 1.52, ns). Multivariate analysis of RFS showed age as the only independent prognostic factor. Multivariate analysis of RFS for diploid tumors showed no independently significant factor; however, age as a continuous variable with a relative risk of 1.04 and SPF with a relative risk of 2.94 were of borderline significance. Our results suggest that abnormalities of the nuclear DNA content and SPF in this homogeneous group of patients are associated with clinical and morphological prognosticators; however, ploidy is no independent prognostic factor for RFS. For diploid tumors, SPF might be a possible independent prognostic factor.

Aged↗
PubMed1995

Effect of timing of surgery during the menstrual cycle of premenopausal breast cancer patients.

BACKGROUND: In 1989 it was suggested that the timing of surgery during follicular or corpus luteum phase of the menstrual cycle could substantially influence the survival time in premenopausal breast-cancer patients [1]. Several researchers analysed their data, but in general they could not confirm this observation. Nevertheless, two other reports in that series found some influence of the time of surgery during menstrual cycle on prognosis, although, they suggested different time periods as favourable [8, 9]. PURPOSE: The purpose of this study was to investigate the effect of timing of surgery in a study population which was much larger than the previous studies. METHOD: All premenopausal patients with primary breast cancer who had been operated at one clinic between 1st of January 1980 and 31st of December 1990 were considered eligible for the study. Based on the day of surgery during the menstrual cycle all patients were grouped according to three proposed categories and to an additional one which consisted of the favourable days from the three proposed categories. We investigated the effects of several prognostic factors and of the timing of surgery on three endpoints: recurrence free survival, distant disease free survival, and overall survival. RESULTS: The traditional prognostic factors had effects in agreement with the literature. Of the different categories for timing of surgery none had a significant influence; the strongest in univariate analysis had a p-value of 0.10 and the trend was in the opposite direction to the one proposed in the literature. These results did not change in multivariate analysis with the Cox model. CONCLUSIONS: Timing of surgery does not have an important effect on the prognosis of breast cancer patients. Incorporating other results from the literature, we conclude that it has at most a weak effect. IMPLICATIONS: At present there is no need to incorporate the day of menstrual cycle in the planning of surgery for premenopausal breast cancer patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1995

Differential diagnosis of breast lesions by color Doppler.

Color Doppler allows flow detection in small tumor vessels. Due to the vascularity associated with the growth of malignancies, this method can be used to differentiate between benign and malignant breast lesions. In order to study the typical flow characteristics, we investigated multiple Doppler flow parameters. A UM9 HDI (ATL) was used with a linear transducer L 10-5. The number of tumor vessels and the mean, maximum and total flow velocity were measured in 325 benign and 133 malignant lesions and showed highly significant differences (p < 0.0001). Flow profiles (resistance index and systolic/diastolic frequency ratio) showed a large overlap and did not allow accurate tumor differentiation when mean and minimum values were analyzed. Surprisingly, the maximum resistance index and systolic/diastolic frequency ratio were significantly higher in carcinomas than in benign lesions, but the overlap of the values was wider than the flow velocity measurements. Using the vessel number and the total tumor vascularity, 90% of all lesions could be differentiated. A difficulty that we encountered was that a few cancers have very low flow values and some of the proliferative benign lesions can have increased flow.

Adolescent↗
PubMed1995

DNA flow cytometry in node-positive breast cancer. Prognostic value and correlation with morphologic and clinical factors.

OBJECTIVE: To help clarify the possible usefulness of nuclear DNA content and S-phase fraction (SPF) as additional prognostic factors in node-positive breast cancer patients because there is increased interest in the development of new factors that might provide more detailed prognostic information. STUDY DESIGN: We performed a DNA and SPF analysis by flow cytometry using a multivariate statistical model on a group of 139 node-positive breast cancer patients with clearly defined inclusion and exclusion criteria. RESULTS: The percentage of aneuploidy increased with the number of involved nodes. Aneuploid tumors were more often found among grade 3 and among receptor-negative tumors. Univariate analysis showed a strong effect on recurrence-free survival (RFS) for the number of involved nodes (P < .001) and for tumor size (P = .013). Grade 3 and receptor-negative tumors showed a nonsignificant trend toward increased risk. The relative risk of aneuploid tumors was 1.19 (95% confidence interval, 0.75-1.87). Multivariate analysis revealed only the number of involved nodes to be an independent prognostic factor (P = .002); ploidy showed no effect (P = .684). SPF did not show any significant effect on RFS, even in a univariate analysis. CONCLUSION: These results suggest that nuclear DNA content and SPF correlate with morphologic factors. Their routine clinical use, however, in node-positive breast cancer patients receiving adjuvant therapy seems to have no clinical relevance and therefore can be omitted.

Aneuploidy↗
PubMed1994

Cellular DNA content and survival in advanced ovarian carcinoma.

BACKGROUND: The prognosis of patients with advanced ovarian cancer is generally poor. To date, no satisfactory methods for predicting individual prognosis have been reported, especially in patients with little or no residual tumor after debulking. METHODS: The authors investigated in a retrospective study the prognostic significance of nuclear DNA content as measured by flow cytometry of the tumor specimens from 184 women with nonpretreated International Federation of Gynecology and Obstetrics Stage III and IV ovarian cancer. Clearly defined inclusion criteria for the study population were used. RESULTS: Seventy-one (39%) cancers were diploid, whereas 113 (61%) were aneuploid. Ploidy showed a significant correlation with clinical and morphologic features such as age, histologic grade, serous histologic type, and residual tumor after debulking. No significant correlation was found between ploidy and ascites, estrogen- and progesterone receptor levels, and elevated pretreatment CA-125 levels. Univariate analysis showed significant correlations between overall survival and histologic grade (P = 0.003), patient age (P = 0.001), residual tumor after primary surgery (P < 0.001), stage (P = 0.019) and ploidy (P = 0.009). Multivariate analysis revealed residual tumor (P < 0.001) and age (P = 0.051) to be associated independently with survival. Ploidy was not established as an independent prognostic factor. CONCLUSIONS: These results suggest that abnormalities of the nuclear DNA content in advanced ovarian carcinomas are associated with various clinical and morphologic prognosticators, but that ploidy is not an independent prognostic factor for survival.

Adult↗
PubMed1994

Human papillomavirus DNA in cervical carcinoma--correlation with clinical data and influence on prognosis.

Human papillomavirus (HPV) is a main factor in cervical carcinogenesis. However, data on the correlation of HPV with clinical features and the prognosis of cervical carcinoma remain controversial. The HPV status (positivity, type, copy number) in unfixed tissue specimens of 205 primary invasive cervical carcinomas was determined by Southern blot hybridization. A correlation with comprehensive clinical and histopathologic data and long-time survival was evaluated. HPV DNA was detected in 73% of the cases; 83% of the HPV-positive tumors contained HPV 16. HPV 16 was predominant among squamous-cell carcinomas (SCC) (p = 0.05). HPV 16 copy number was higher in keratinizing tumors (p < 0.05), and elevated levels of the SCC antigen were more common in patients positive for HPV 16 (p < 0.03). No association was found between the HPV status and 8 other clinical and histopathologic variables. Multivariate analysis after a median follow-up of 73 months demonstrated longer survival for patients with lower clinical stage (p = 0.001) and keratinizing SCC (p = 0.005). Women with HPV-negative tumors had a higher risk of death (RR 1.51; p = 0.07). HPV analysis does not clearly define biologically distinct sub-sets of cervical carcinoma. This underlines the importance of additional factors in cervical carcinogenesis.

Adenocarcinoma↗
PubMed1994

Quantitative flow measurements for classification of ovarian tumors by transvaginal color Doppler sonography in postmenopausal patients.

Color Doppler and Duplex measurements were obtained in 83 (42 benign, 41 malignant) ovarian tumors in postmenopausal patients. An ATL UM9/HDI was used. The following flow criteria were analyzed: lowest resistance index (RI) and pulsatility index (PI), total number of arteries and number of central arteries and the maximum, mean and sum of systolic, end-diastolic and time-averaged maximum velocities of all intratumoral vessels. In 98% of malignant and in 85% of benign lesions, vessels were detected. All flow criteria showed highly significant differences between benign and malignant tumors (p < 0.0001). However, there was a considerable overlap between benign and malignant tumors (e.g. the median of the lowest RI was 0.62 (range 0.26-1.0) for benign and 0.40 (0.22-0.66) for malignant tumors; the median of the maximum systolic velocity was 17.5 cm/s (range 5.2-61.5 cm/s) for benign and 47.05 cm/s (14.6-105.0 cm/s) for malignant tumors). Differentiation of malignant tumors by the lowest RI and PI, number of arteries and maximum of systolic flow velocities gave a sensitivity of 77-85%, specificity of 77-83% and accuracy of 80-84%. Differentiation was superior by calculation of the maximum end-diastolic velocities and by the summation of the systolic, end-diastolic and time-averaged maximum flow velocities: sensitivity 90-9.5% specificity 83-86% and accuracy 87-91%. This study confirms that a single measurement is not sufficient for an accurate differentiation of ovarian lesions and, besides the measurement of minimum RI and PI, the measurements of flow velocities as Doppler criteria play an important role.

Journal Article↗
PubMed1994

Co-expression of M-CSF transcripts and protein, FMS (M-CSF receptor) transcripts and protein, and steroid receptor content in adenocarcinomas of the ovary.

The co-expression of M-CSF (CSF-1) and its receptor in specimens of ovarian cancer has recently been reported. Preliminary results have already suggested a possible influence of steroids on FMS (M-CSF receptor) expression. Fifty-five non-pretreated FIGO stage III/IV ovarian adenocarcinomas were studied for M-CSF transcripts and protein, as well as FMS transcripts and protein, using standard molecular biological techniques (Northern blot, slot blot analysis) and immunocytochemistry (ICC). Steroid receptor content was measured by DCC analysis in 44/55 specimens; in addition, ER/PR (oestrogen/progesterone) ICC was performed in 32/55 specimens. All tumours were shown to contain M-CSF-specific mRNA. Likewise, M-CSF protein was detected by ICC in the stroma and over the epithelium in all specimens. However, while most tumours were shown to contain FMS-specific mRNA, only 64 per cent of cases showed significant expression of FMS protein by tumour epithelium as shown by ICC. A statistically significant positive correlation was found between M-CSF and FMS mRNA expression levels. A week non-significant positive correlation was noted between FMS mRNA expression levels and tumour grade. Carcinomas were ER-positive in 66 per cent (DCC) or 34 per cent (ICC), and PR-positive in 73 per cent (DCC) or 34 per cent (ICC). A statistically significant positive correlation between ER (DCC) and M-CSF mRNA expression levels was found. Weak non-significant correlations were present between ER (ICC) and FMS (ICC), as well as between PR (DCC) and FMS mRNA expression.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1994

Color Doppler flow criteria of breast lesions.

Color Doppler technique has been available for several years. The sensitivity of the equipment has improved and allows for assessment of tumor vascularity. We investigated multiple parameters in 258 patients, with 176 benign and 82 malignant lesions to define characteristic flow criteria. Median (25-75% quartiles) and p-values are given for benign vs. malignant lesions. Number of tumor vessels: 2 (1-2) vs. 8 (5-14), p < 0.0001; mean peak systolic flow velocity: 11.1 cm/s (6.4-14.9) vs. 18.8 cm/s (13.7-25.1), p < 0.0001; maximum flow velocity: 12.5 cm/s (6.7-18) vs. 32.5 cm/s (22.5-47.3), p < 0.0001; sum of all systolic flow velocities: 18.9 cm/s (7-34.2) vs. 147 cm/s (71.3-266.7), p < 0.0001; minimum systolic flow velocity: 8.9 cm/s (5.4-12.1) vs. 9 cm/s (6.3-11.3), p > 0.05; average resistance index (RI): 0.68 (0.58-0.72) vs. 0.75 (0.67-0.81), p > 0.05; maximum RI: 0.71 (0.65-0.78) vs. 0.88 (0.78-0.99), p < 0.0001; minimum RI: 0.64 (0.57-0.68) vs. 0.64 (0.53-0.71), p > 0.05; average A/B ratio: 3.1 (2.7-3.7) vs. 4.3 (3.2-7.7), p < 0.0001; maximum A/B ratio: 3.4 (2.9-4.6) vs. 8.4 (4.5-9.9), p < 0.0001; minimum A/B ratio: 2.8 (2.3-3.2) vs. 2.9 (2.2-3.5), p > 0.05. The data analysis shows that flow resistance in malignancies is increased. This is in contrast to gynecological malignancies, where an increased diastolic flow indicates that flow resistance is decreased.

Adolescent↗
PubMed1994

[Transvaginal color-coded Doppler ultrasound in ovarian tumors].

In 129 patients with ovarian tumours, a preoperative examination by transvaginal colour Doppler sonography (ATL UM9 HDI) was performed. 45 were malignant and 84 benign. 46 patients were premenopausal and 83 postmenopausal. All tumour vessels were analysed by spectrum analysis. The number of tumour vessels and the lowest resistance index (RImin) and pulsatility index (PImin) of all vessels were evaluated as diagnostic criteria of the neovascularisation. Up to 19 vessels were found in 115 (89%) tumours. In benign lesions, the number of vessels was significantly lower than in malignancies (median 3 versus 9, p < 0.0001). The RImin and PImin values between benign and malignant tumours were also significantly different, independent of the menopausal status. In postmenopausal patients, the median RImin in 42 benign tumours was 0.62 (0.26-1.0) and in 41 malignancies 0.40 (0.22-0.66). The median PImin was 0.98 (0.31-5.84) in benign tumours and 0.53 (0.25-1.22) in malignant tumours. However, due to the overlapping range between benign and malignant tumours, these parameters do not allow an accurate differentiation. With a cut off value for RImin = 0.5 and PImin = 0.7, the sensitivity is 85% or 82.5% respectively. The specificity for RImin and PImin is 77%, and the diagnostic accuracy is 84% and 80% respectively. The correlation coefficient between RImin and PImin is 0.99 in benign and malignant tumours and both indices are adequate. The calculation of the RI is more easily available and should be preferred as a diagnostic parameter.

Adolescent↗