Treatment of hereditary angioneurotic oedema (HANE) with tibolone.

OBJECTIVE: Eight women, aged 25-58 years, with hereditary angioneurotic oedema (HANE) were treated with tibolone, a synthetic steroid exhibiting oestrogenic, androgenic and progestational activity. DESIGN: Pilot study. RESULTS: Tibolone at a dose of 2.5-7.5 mg/day significantly reduced the number and severity of attacks and the number of ampoules of C1-esterase inhibitor (C1-INH) needed for symptomatic therapy. The efficacy of tibolone was comparable to that of danazol, while the androgenic side-effects were considerably reduced. CONCLUSIONS: Tibolone may represent an alternative to danazol administration for the prophylaxis of HANE in women.

[Automated mammary sonography and mammography: the differentiation of benign and malignant breast lesions]. / Automatisierte Mammasonographie und Mammographie: Differenzierung benigner und maligner Mammaläsionen.

PURPOSE: A prospective study on the differentiation of breast lesions was carried out using experimental combination schemes of mammography and automatic sonography. MATERIALS AND METHODS: X-ray mammograms and a B image from automatic sonography of 39 malignant and 41 benign lesions as well as 40 cases without lesions were separately examined by four experienced diagnosticians. The observers differentiated the findings mammographically and by measurement in the B images. RESULTS: For two examiners the combination of mammography and automatic sonography gave with regard to the differentiation of breast lesions an improvement in sensitivity of 3 or 5% and in specificity of 31 and 18%, respectively, as compared to mammography alone while for the other two examiners an improved specificity of 21 and 36%, respectively, was accompanied by an 8 and 10% decrease in sensitivity as compared to mammography alone. CONCLUSIONS: The differentiating criteria from automatic sonography and mammography can, in principle, be used to evaluate the dignity of breast lesions. However, an optimization is necessary since the improvement in specificity does not compensate the loss in sensitivity.

Detection of malignant and benign breast lesions with an automated US system: results in 120 cases.

PURPOSE: To evaluate clinically an automated ultrasound (US) system for detecting benign and malignant breast lesions. MATERIALS AND METHODS: A prototype automated US system was used to examine 119 patients: 38 patients with 39 proved malignant breast lesions (7-50 mm), 41 patients with 41 proved benign breast lesions (8-40 mm), and 40 patients without breast lesions. The device yields a three-dimensional set of B-mode scans and reconstructed US images comparable to mammograms. All patients had undergone mammography. Four radiologists who had not performed the examinations independently assessed the mammograms and US images to detect benign and malignant breast lesions. RESULTS: Each of the four readers did not recognize one to three detectable malignant lesions on mammograms, one to two detectable malignant lesions on US images, two to four detectable benign lesions on mammograms, and five to seven detectable benign lesions on US images. All readers identified the 39 cancers with at least one of the modalities. The 40 cases without lesions were diagnosed correctly more frequently on the US images by three readers and on the mammograms by one reader. CONCLUSION: Depiction of breast lesions at automated US is reproducible. Automated US is complementary to mammography.

[Interventional techniques in breast diagnosis: ultrasound controlled puncture biopsy]. / Interventionelle Techniken in der Mammadiagnostik: sonographisch gezielte Stanzbiopsie.

From May 1, 1992 to April 30, 1993, we performed 307 ultrasonic guided, high-speed core cut biopsies. In 119 of the 307 women, we dispensed with further surgical and histological procedures when the tentative diagnosis from complementary mammary diagnostic procedures revealed no pathological findings and concurred with the histological results of the core cut biopsy. In 188 women, the biopsy was followed by surgical intervention and correlation of the histological findings. This group of patients showed a sensitivity of 98%, a specificity and positive predictive value of 100%, and a negative predictive value of 91%. If we combine the results of the complementary mammary diagnostics (including the core cut biopsy), then the sensitivity, specificity, and positive and negative predictive values for this surgically and histologically confirmed group of patients reach 100%. In trained hands, the ultra-sonic-guided, high-speed core cut biopsy is a reliable means for determining the histological nature of lesions detected in ultrasonic scans. This technique has been perfected in our facility. Along with preoperative carcinoma detection, it permits us to avoid unnecessary operations when, under defined conditions, there are no pathological findings.

[An unusual case of endometriosis]. / Ungewöhnlicher Fall von Endometriose.

Endometriosis can be found in 10 to 20% of all menstruating women. Most often the lesions are localized in the pelvis, but in rare cases they can be found in almost every region of the body. The diagnostic clue is the typical history of premenstrual pain. Imaging can demonstrate the site and size of extra-pelvic lesions and an image-guided diagnostic puncture for histological diagnosis can be done.

[Sarcoidosis. Case report of a patient with isolated sarcoidosis of the breast]. / Sarkoidose der Mamma. Fallbericht einer Patientin mit isolierter Sarkoidose der Mamma.

The case of a 41-year-old woman with sarcoidosis of the breast without evidence of disease elsewhere is reported. The diagnosis was established histologically, and other causes of the sarcoid-like granulomatous lesions could be excluded.