[Effectiveness of various forms of therapy in chronic cardiovascular diseases--a vector analysis of the transition probabilities of degrees of severity]. / Effektivität differenter Therapieformen bei chronischen Herz-Kreislauf-Krankheiten--eine Vektorenanalyse der Ubergangswahrscheinlichkeiten von Schweregraden.

The present findings result from a check of probationers representative for approx. 280,000 inhabitants of defined territories, who had been designated as suspects of heart and vessel disease on grounds of X-ray-morphological criterions (classification by Richter). Those about 3,000 suspects, subdivided into 3 comparable patient groups A, B and C, underwent different regimes of treatment of outpatient medical practice after standardized and noninvasive diagnostics in a follow-up during 5 years and had been valued by means of a problem-specific grading. The comparative analysis about the distribution of severe degrees concerning hypertension and coronary heart disease after the conclusion of the intervention showed significant differences concerning the results of treatment to the credit of the patient group A (treated by specialists) contrary to the patient group B (treated by family doctors) and patient group C (principle of announcing the patients themselves). Also the patient group B showed significantly better results of therapy compared with the patient group C. In addition to the concluding rating the estimation of yearly transition of severe degrees gave an insight into the therapeutical decision of the person who looks after as well as the different distribution of severe degrees of special heart diseases in dependence on the starting severe degree in the special period of intervention conditioned on the therapy. The results gain exceptional importance for practice on the grounds of methodics of the study-automatable classification of dv-thorax-X-ray pictures, problem-specific grading of noninvasive, simple parameters, variants of therapy in dependence on the graduated system of medical care.

[Rare vascular findings in CT of the upper mediastinum]. / Seltene Gefässbefunde im CT des oberen Mediastinums.

The CT findings of malformation of major veins near the heart are described (one case of persistent left superior vena cava and two cases of partial anomalous pulmonary veins) as well as one malformation of the pulmonary artery (vascular sling). These findings demonstrate the vascular character of the lesion and the procedure permits detailed clarification of the abnormality.

Bilateral atrial myxomas. Surgical correction after echocardiographic diagnosis.

A case is reported of bilateral atrial myxomas diagnosed noninvasively by echocardiography and successfully removed. The excised tumor mass consisted of a mobile right atrial myxoma prolapsing into the right ventricle and a less mobile, not prolapsing myxoma in the left atrium. The operation was performed entirely on the basis of echocardiographic findings, which correlated well with the operative results. Further investigation by computer tomography verified the diagnosis, but added no extra information of importance for therapy. Diagnostic aspects of the combined application of M-mode and cross-sectional echocardiography with Doppler echocardiography are emphasized. Postoperative follow-up echocardiography showed the complete removal of the myxomas and improvement of cardiac function.

[Evaluation of computerized tomograms using a black and white and a color monitor: an ROC (receiver operation characteristic) comparison]. / Die Auswertung von Computertomogrammen am Schwarzweiss- und am Farbmonitor: Ein ROC-Vergleich.

Different views about the value of a colour monitor for the evaluation of computer tomograms have prompted us to carry out this ROC (Receiver Operation Characteristic) examination. The latter was based on patient computer tomograms in which lesions of the liver were simulated by image manipulation. 5 radiologists analysed the image material (a) on a black-and-white monitor, (b) on a colour monitor, and (c) simultaneously on a black-and-white and a colour monitor. The study shows that the use of a colour monitor gives no essentially different result than evaluation with a black-and-white monitor. The slightly better result of 2% more true positive findings with simultaneous representation of black-and-white and colour image relative to the sole use of black-and-white display is within error limits. The colour representation gives no advantage for the evaluation of usual computer tomograms because the window technique enables a contrast representation in black-and-white too.

[Diagnosis of heart tumors--contribution of 2-dimensional and Doppler echocardiography]. / Zur Diagnostik von Herztumoren--Beitrag der zweidimensionalen und Doppler-Echokardiographie.

The advantages of the modern two-dimensional echocardiography in comparison to the M-mode one are investigated on the basis of findings in 7 patients with heart tumors. Also the possibilities of Doppler echocardiography for comprehensive information about the cardiac situation in these patients are demonstrated. It will be shown that in some patients operation can be performed entirely on the basis of echocardiographic findings.

[CT-guided sclerosing therapy of kidney cysts. Report of experience with 100 patients]. / CT-gezielte Nierenzystenverödung. Erfahrungsbericht über 100 Patienten.

Due to its diagnostic accuracy as well as safe and accurate puncture technique CT can be used advantageously for percutaneous sclerosing therapy of renal cysts. CT-guided sclerosing therapy with pantopaque emulsions was carried out in 100 patients on an outpatient basis with altogether 107 solitary renal cysts. There were indications in all cases. Continuous follow-up of cyst involution in 96 patients with 103 cysts pointed out a reliable sclerosing effect in 95.1% of them. Major complications were neither registered in the puncture technique nor in the late urographic examinations.

[Are thoracic radiographs in the recumbent position useful in the diagnosis of chronic left heart insufficiency? Comparison of x-ray findings with left ventricular hemodynamics]. / Sind Röntgenthoraxaufnahmen im Liegen für die Diagnose der chronischen Linksherzinsuffizienz verwendbar? Ein Vergleich der Röntgenbefunde mit der linksventrikulären Hämodynamik.

108 patients (88 male, mean age 50 years, 20 female, mean age 49) having coronary heart disease (40), cardiomyopathy (39), hypertension (9), valvular disease (9), pulmonary diseases (5) and without cardiac diseases (6) underwent chest plain radiographs in standing and recumbent position immediately before being investigated invasively by left and right heart catheterisation, angiocardiography and coronary angiography. Two experienced radiologists evaluated the plain films with special reference to the findings of the heart and lung vessels, particularly the pulmonary veins. Dilatated veins of the upper lobes were observed more often if the radiograph was obtained from the recumbent patient. A significant close correlation with increased LVEDP was, however, revealed in both positions. A possible simulation of pathological dilatation of the venous trunci of the upper lobes merely due to the redistribution of the blood flow in the horizontal position was excluded. The results show that reliable conclusions can be drawn concerning chronic left ventricular failure if the characteristic pulmonary vein findings are visualised in patients both in the standing and in the recumbent position.

[The importance of echocardiography for the diagnosis of cardiomyopathies in comparison to cardio-computer tomography and to complex invasive heart diagnostics]. / Die Bedeutung der Echokardiographie für die Diagnostik der Kardiomyopathien im Vergleich zur Cardio-Computer-Tomographie und zur komplexen invasiven Herzdiagnostik.

112 patients with various forms of cardiomyopathy (typical-subaortic--hypertrophic obstructive; atypical--medioventricular--hypertrophic obstructive; hypertrophic nonobstructive; apical hypertrophic; dilatative) were subjected to echocardiographic examination of the morphological and functional state of the heart. The results were compared with the results of computer heart tomography and comprehensive invasive examination. The high diagnostic reliability of ultrasonic diagnostics has been confirmed. Invasive examination is necessary in hypertrophic nonobstructive and in dilatative cardiomyopathies. Computer heart tomography is suitable for complementing findings and for clarifying contradictory results of examination, especially in apical forms of cardiomyopathy.

[Random sample size in ROC analyses]. / Zur Frage des Stichprobenumfangs bei ROC-Analysen.

ROC analysis has proved useful in assessing diagnostic efficiency. Large x-ray film series of thoracic images intended for cardiovascular diagnosis were used for studying diagnostic efficiency in relation to random sample size. Exploration of random samples from two classes of findings requiring diagnostic differentiation, with the same number of x-ray films in each class, showed satisfactory convergence between the radiologists' rating and the ROC curve if the size of the random sample groups was about 200 images each or larger. The smaller the random sample size (less than 200 images), the greater the scatter of the rating performance. In another series the rating ability of experienced radiologists was compared with that of a semi-automatic classificator. The semi-automatic classificator attained almost the same performance index as the low-performance evaluator.

[ROC (receiver operating characteristic) study for the recognition of liver lesions on the computer tomogram]. / ROC-Untersuchung zur Erkennbarkeit von Leberläsionen in Computertomogrammen.

ROC examination was based on patient computer tomograms, in which lesions of the liver were simulated by image manipulation. The window width for optimal recognition of the lesions was found to be 128 Hounsfield units (HU). Evaluation of Receiver Operating Characteristics (ROC) by diameters and contrasts of the lesions yielded a contrast detail diagram largely reflecting conditions in clinical practice. The detectability--measured via the smallest visible diameter of the lesions--is inferior by the factor 3 to 60 to the results obtained with hole pattern phantoms. For example, in computer tomograms lesions of the liver of 24 mm and 4 HU or also 11 mm and 10 HU yield 70% true positive and 10% false positive findings.

[Reconstruction of the pulmonary artery in parenchyma-preserving lung resections for bronchial cancer]. / Rekonstruktive Massnahmen an der Pulmonalarterie bei parenchymerhaltenden Lungenresektionen wegen Bronchialkarzinoms.

Parenchyma-preserving resection techniques with broncho- and angioplastic methods contribute to avoid palliative pneumonectomy in cases of extended bronchial carcinoma (greater than T2; greater than N1). 18 cases are analysed.

[An analysis of the diagnostic information derived from screening as against films during radiological examination of the stomach (author's transl)]. / Analyse des diagnostischen Informationswertes von Aufnahmen und Durchleuchtung bei der Röntgenuntersuchung des Magens.

The value of screening procedures (with image intensifiers and television monitor) was compared with films during the radiological examination of the stomach, using a double contrast method. In one experiment, the diagnostic accuracy of experienced radiologists using screening only was compared with standardised films. There was a definite improvement using films. The reason for this was not the difference in the technical excellence of the images, but depended on the cognitive processes which lead the doctor to a diagnosis. For this purpose, static pictures provide a better basis than dynamic, rapidly changing and brief views seen during screening. The results lead to certain considerations concerning the methods for the radiological examination of the stomach.

[Explanations for the standard in roentgen diagnosis: basic tests of the thoracic organs--adults]. / Erläuterungen zum Standard Röntgendiagnostik: Basisuntersuchung der Thoraxorgane--Erwachsene.

Explanations are given concerning the standard of radiodiagnostics--basis examination of the organs of the thorax/TGL-No. 36661, which shall facilitate the understanding of the parameters given. It results from the fact that the roentgenological examination of the organs of the thorax begins with a posterior-anterior ray-path radiograph of the thorax. In these cases the large format technique with film-foil-combination and the fluorography are classified as equivalent. With regard to the high speed of movement to be expected is striven for the achievement of possibly short times of exposure. The authors briefly enter the particularities of the radiograph of the thorax in lateral as well as in the full size radiograph sitting and lying positions and at the patients bed. Due to the law solution and the higher radiation dose the fluoroscopy is to be used only with regard to the findings and other information concerning the patient.