[Malignant hypertension in a single kidney with doubled blood vessel supply]. / Maligne Hypertonie bei Einzelniere mit doppelter Gefässversorgung.

HISTORY: A 72-year-old male in acute renal failure, intubated and ventilated, was transferred to our hospital. He had a 30-years history of severe hypertension and signs of general atherosclerosis. 25 years ago, the left kidney had been removed because of an ischaemic renal infarction due to a renal artery stenosis. Blood pressure-monitoring showed excessive high systolic (up to 250 mmHg) and diastolic (up to 160 mmHg) blood pressure. INVESTIGATIONS: The MRI-scan revealed a single right kidney with a main artery and an accessory one, both with a severe ostial stenosis. The resistance index (RI) value, measured by duplex ultrasonography was 44. DIAGNOSIS AND TREATMENT: In two interventional procedures both stenosed arteries were dilated a stent was applied. Afterwards blood pressure and renal function improved. CONCLUSIONS: Severe hypertension can be caused by a renal artery stenosis. It can be diagnosed by duplex ultrasonographic studies, which has the advantage of determining the RI and therefore identifying patients with no improvement of blood pressure or renal function after resolving the stenosis. The angioplasty with or without a stent is as successful as an operation but has less complications.

[Diagnosis of poly-orchidism]. / Zur Diagnostik der Polyorchie.

In a patient referred for sclerotherapy of a varicocele, three testicles and focal atrophy in one testicle were additionally diagnosed by ultrasound and MR. In the literature other diseases are occasionally described accompanying this rare benign congenital anomaly.

[Comparison of x-ray plain films, x-ray tomograms and computed tomograms in lung nodules in children and adolescents]. / Vergleich von Röntgenübersichtsaufnahmen, Röntgenschichtaufnahmen und Computer-tomogrammen bei pulmonalen Rundherden im Kindes- und Jugendalter.

A comparison was carried out of the value of plain radiographs, tomography and CT in 37 patients aged between five and 24 years. The majority of these patients had an osteosarcoma. Thirty-five CT examinations were performed on 16 patients and about 300 foci were demonstrated. Plain radiographs only showed 50%, and tomograms only 70% of these lesions. Surgery was carried out in 34 patients and there was agreement between the findings at thoracotomy and radiology in about half the cases. Frequently, more metastases were found at operation than could be demonstrated radiologically, in a few cases there were fewer.

[Megaduodenum with non-rotation]. / Megaduodenum bei nonrotation.

In a 16-year-old girl who suffered from non-characteristic upper abdominal complaints, the gastrointestinal passage revealed an extreme megaduodenum associated with nonrotation. Intraoperatively, congenital adhesions were found as cause which had stenosed the duodenojejunal transition and had become fixed in the right upper abdomen. After separating the adhesions, resecting the stenosis and narrowing the duodenum, intestinal continuity was restored by means of an end-to side duodenojejunostomy. The causes, signs, diagnosis and therapy of the megaduodenum are discussed.

Thymolipoma in association with myasthenia gravis.

Among 72 thymic tumors that were examined we have found five (7.5%) thymolipomas. Two of these patients have had clinical symptoms. One, a five-year-old boy, has had an erythrocyte hypoplasia as well as a hypogammaglobulinemia. The other patient, a 56-year-old man, has had myasthenia gravis. This case is the second in the world literature in which a thymolipoma is associated with symptoms of myasthenia gravis. The clinical, radiologic, and histopathologic findings and the pathogenesis of thymolipoma are discussed.

[Computer tomographic findings in tumours of the oesophagus (author's transl)]. / Computertomographische Befunde beim Osophagustumor.

The computer tomographic findings in 55 patients with histologically confirmed oesophageal carcinomas and in three benign oesophageal tumours are described. In 49 cases, the carcinoma was clearly visible on computer tomography, but in six cases, the tumour was not seen. In another six cases, infiltration into the mediastinum and trachea was demonstrated. In seven patients, regional lymph node metastases were found. The value of computer tomography in oesophageal carcinomas lies in the ability to demonstrate axial spread of the tumour, and the presence of lymphatic or haematogenous metastases during the one examination. This helps in the choice of surgery or in the planning of radiation treatment. Demonstration of the thickness of the oesophageal wall in the region of the tumour can be improved by using a flour-gastrografin paste.

[Computer tomographic diagnosis of traumatic lesions of the spleen (author's transl)]. / Computertomographische Diagnostik traumatischer Milzläsionen.

The computer tomographic appearances of 16 traumatic lesions of the spleen have been analysed. The changes n the spleen were related to the subsequent therapeutic procedures. The clinically important distinction between parenchymal rupture and parenchymal-capsular rupture can always be made with certainty. CT also adds information concerning parasplenic abnormalities, traumatic changes in upper abdominal organs and additional injuries to other parts of the body.

[Computed tomography of the mediastinum in myasthenia gravis. Normal findings, thymic hyperplasia, thymomas (author's transl)]. / Computertomographie des Mediastinums bei Myasthenia gravis pseudoparalytica. Normalbefund--Thymushyperplasie--Thymustumoren.

Computed tomography of the mediastinum was performed in 45 patients with myasthenia gravis. Surgery was carried out in fourteen. Amongst these, there were four thymomas, one thymolipoma, eight thymic hyperplasias and one normal thymus gland. A further patient, who did not have surgery, probably also had a thymic tumour. The normal thymus and thymic hyperplasia cannot be distinguished on computed tomography. Differentiation of small thymomas from normal thymus is not always possible. Invasion by thymomas can only be appreciated with large tumours.

[X-ray examination of the operated intestine in Crohn's disease. (author's transl)]. / Röntgenuntersuchung des operieten Darmes bei Morbus Crohn.

Since Crohn's disease often entails complications, surgery is mandatory in many cases. The postoperative relapse rate is high (50-90%). The most important method to discover such relapses is represented by x-ray examination. In 15 surgically treated cases, relapses were observed in 7 patients. The region of the anastomosis is most frequently affected by relapses and complications. Optimal information in respect of differentiation of purely surgically conditioned changes and relapses is given by enteroclysm and double-contrast roentgenography of the colon.