Discordant and false-negative interpretations at digital breast tomosynthesis in the prospective Oslo Tomosynthesis Screening Trial (OTST) using independent double reading.

Objectives: To analyze discordant and false-negatives of double reading digital breast tomosynthesis (DBT) versus digital mammography (DM) including reading times in the Oslo Tomosynthesis Screening Trial (OTST), and reclassify these in a retrospective reader study as missed, minimal sign, or true-negatives.

Methods: The prospective OTST comparing double reading DBT vs. DM had paired design with four parallel arms: DM, DM + computer aided detection, DBT + DM, and DBT + synthetic mammography.

BI-RADS Density Classification From Areometric and Volumetric Automatic Breast Density Measurements.

Rationale And Objectives: The aim of our study was to classify breast density using areometric and volumetric automatic measurements to best match Breast Imaging-Reporting and Data System (BI-RADS) density scores, and determine which technique best agrees with BI-RADS. Second, this study aimed to provide a set of threshold values for areometric and volumetric density to estimate BI-RADS categories.

Materials And Methods: We randomly selected 537 full-field digital mammography examinations from a population-based screening program.

Classification of fatty and dense breast parenchyma: comparison of automatic volumetric density measurement and radiologists' classification and their inter-observer variation.

Background: Automatically calculated breast density is a promising alternative to subjective BI-RADS density assessment. However, such software needs a cutoff value for density classification.

Purpose: To determine the volumetric density threshold which classifies fatty and dense breasts with highest accuracy compared to average BI-RADS density assessment, and to analyze radiologists' inter-observer variation.

Interpretation of automated breast ultrasound (ABUS) with and without knowledge of mammography: a reader performance study.

Background: Automated breast ultrasonography (ABUS) has the potential to be an important adjunct to mammography in women with dense breasts.

Purpose: To compare reader performance and inter-observer variation of ABUS alone and in combination with mammography.

Material And Methods: This retrospective study had ethical committee approval.

Two-view digital breast tomosynthesis screening with synthetically reconstructed projection images: comparison with digital breast tomosynthesis with full-field digital mammographic images.

Purpose: To compare the performance of two versions of reconstructed two-dimensional (2D) images in combination with digital breast tomosynthesis (DBT) versus the performance of standard full-field digital mammography (FFDM) plus DBT.

Materials And Methods: This trial had ethical committee approval, and all participants gave written informed consent. Examinations (n = 24 901) in women between the ages of 50 and 69 years (mean age, 59.

[Bariatric surgery - significance, risks, long term consequences].

In recent years the number of bariatric surgery has markedly increased in industrial nations. Surgery provides a more rapid decrease of body weight than conservative approach. However a long term conservative follow up therapy is mandatory to stabilize reduced weight.

Prospective trial comparing full-field digital mammography (FFDM) versus combined FFDM and tomosynthesis in a population-based screening programme using independent double reading with arbitration.

Objectives: To compare double readings when interpreting full field digital mammography (2D) and tomosynthesis (3D) during mammographic screening.

Methods: A prospective, Ethical Committee approved screening study is underway. During the first year 12,621 consenting women underwent both 2D and 3D imaging.

[Therapy for obesity--conservative and/or surgical?].

On comparing surgical and conservative approaches in therapy for obesity it is accepted that there is a more rapid decline in body weight after surgery than by conservative measures. In contrast to widespread convictions, it has been shown that even in extreme obesity (BMI>60 kg/m²) both a meaningful and a long-lasting reduction of body weight is possible by conservative approach. There is an increasing body of evidence that bariatric surgery, especially malabsorptive and combined forms, causes endocrine disturbances and both vitamin and micronutrient deficiencies.

Comparison of digital mammography alone and digital mammography plus tomosynthesis in a population-based screening program.

Purpose: To assess cancer detection rates, false-positive rates before arbitration, positive predictive values for women recalled after arbitration, and the type of cancers detected with use of digital mammography alone and combined with tomosynthesis in a large prospective screening trial.

Materials And Methods: A prospective, reader- and modality-balanced screening study of participants undergoing combined mammography plus tomosynthesis, the results of which were read independently by four different radiologists, is under way. The study was approved by a regional ethics committee, and all participants provided written informed consent.

Digital breast tomosynthesis (DBT): initial experience in a clinical setting.

Background: Digital breast tomosynthesis (DBT) is a promising new technology. Some experimental clinical studies have shown positive results, but the future role and indications of this new technique, whether in a screening or clinical setting, need to be evaluated.

Purpose: To compare digital mammography and DBT in a side-by-side feature analysis for cancer conspicuity, and to assess whether there is a potential additional value of DBT to standard state-of-the-art conventional imaging work-up with respect to detection of additional malignancies.

[Assessment of additional health care needs of persons with restricted competence in daily life: problems and possible solutions].

A brief general view was given on the public German care insurance. Stressing somatic care, persons with restricted competence for daily life activities are recorded insufficiently. An instrument for documentation of those restrictions was presented.

[Unconventional treatment methods in multiple sclerosis and their expert assessment].

Unorthodox therapies are used also by MS-patients very frequently. Not all procedures are harmless affecting only the purse. The medical expert working within the German health care system will also be called for questions of compensation of costs.

Preliminary experiences and results with the Munich version of the Andreasen Scale. Assessment of productive and negative symptoms in chronic schizophrenic patients.

The Andreasen Scale (SANS), an instrument for evaluating negative symptoms in schizophrenic patients, was translated at the Psychiatric Hospital of Munich and tested on 35 chronic schizophrenic inpatients at the Regensburg State Mental Hospital. In addition, psychopathology was evaluated with the BPRS, sociodemographic data were collected, and cognitive performance was evaluated by the MMS. Also, VBR was determined on the basis of CAT scans.

Psychomotor disturbances in psychiatric patients as a possible basis for new attempts at differential diagnosis and therapy. II. Cross validation study on schizophrenic patients: persistence of a "psychotic motor syndrome" as possible evidence of an independent biological marker syndrome for schizophrenia.

This study investigates the existence and course of psychomotor symptoms in schizophrenic patients (n = 57, both treated and untreated with antipsychotic drugs) as compared to 25 healthy controls. Previous psychometric studies had suggested the existence of a "psychotic motor syndrome" (PMS) both in (untreated) schizophrenic and endogenous depressed patients, consisting of disturbances of lip and tongue movements, fine and gross movements of the dominant right hand and impaired complex motor coordination of the extremities. We confirmed the existence of the PMS in this study.

Music psychopathology. III. Musical expression and psychiatric disease.

Musical expression of the instrumental playing of 61 mentally ill patients and 29 controls recorded several times was assessed by means of a short polarity profile. The performances were reversibly impaired in correlation with the psychopathology. Musical expression followed a systematic variation according to nosological classification.

No correlation between neuroleptic-induced increase of beta-endorphin serum level and therapeutic efficacy in schizophrenia.

In 23 acute, unmedicated, schizophrenic patients, psychotic behaviour and beta-endorphin serum level were measured before and during four weeks of neuroleptic therapy. Prior to drug treatment, beta-endorphin level of all patients was within the normal range. Neuroleptic therapy induced marked elevations of beta-endorphin in eight subjects; statistical analysis revealed a slight but significant increase for the whole group.

The effect of fluperlapine in acute psychotic patients.

Fluperlapine (NB 106 689), a dibenzazepine chemically and pharmacologically similar to clozapine, was investigated in 28 patients with regard to antipsychotic efficacy and occurrence of adverse effects. In an open early phase II study patients were given fluperlapine over a period of 26 days. The average daily dosage was 300 mg.

[Karl Kraus and psychiatry. An assay].

This essay deals with Karl Kraus' polemics against psychiatry; not only orthodox psychiatry but also psychoanalysis, which at that time was gaining in importance. The introduction is an appreciation of Kraus' significance for the German speaking civilization. Then the two cases, Louis von Sachsen and Prof.

[Norepinephrine turnover under neuroleptic treatment of schizophrenic syndromes (author's transl)].

In 45 psychotic in-patients with the paranoid-hallucinatory syndrome, the psychopathology, the extrapyramidal motor disturbances and 3-methoxy-4-hydroxy-phenylethyleneglycol (MHPG) in CSF were investigated. A 15-day treatment with haloperidol induced significant increase of MHPG in CSF; after 10 days clozapine treatment MHPG was significantly reduced. 10 days later the normal values were reached again.

Clinical and biochemical parameters during neuroleptic treatment. III. Primitive reflexes during neuroleptic treatment.

Palmomental reflex, glabellar reflex and oral responses were studied in the course of a treatment with Haloperidol in 14 psychotic patients with a chronic organic brain damage. An increase of the three responses was found; maximum intensity and frequency of the primitive reflexes were reached during the first 5 days of treatment. There was no correlation found between the intensity of primitive reflexes and changes of psychopathological symptoms, of extrapyramidal scores and of homovanillic acid (=HVA) and 5-hydroxyindoleacetic acid (5=5-HIAA) concentration in cerebrospinal fluid (=CSF).

Clinical and biochemical parameters during neuroleptic treatment. II. Antipsychotic effect of haloperidol in patients with chronic organic brain damage.

The time-course of psychopathological symptoms, of extrapyramidal side effects, and of changes in cerebrospinal fluid (CSF) concentration of homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) were simultaneously studied during Haloperidol treatment of 14 psychotic patients with chronic organic brain damage. After 15 days of treatment significant antipsychotic effect was found, while Parkinsonism scores in clinical and experimental tests increased only slightly. CSF concentration of HVA increased significantly by 150% compared to the baseline value (p less than 0.

Clinical and biochemical parameters during neuroleptic treatment. I. Investigations with haloperidol.

26 patients with a paranoid-hallucinatory syndrome were treated with a fixed daily dose of haloperidol. Psychopathological symptoms and parkinsonism were studied before and during the treatment. HVA and 5-HIAA concentrations in CSF were determined immediately before and after 5 or 15 days of treatment.