ABSTRACT
Real-time ultrasonography is a sensitive screening method in patients with suspected liver tumors. However, sonomorphology does not differentiate between benign and malignant tumors. In a prospective study we examined patients with liver tumors with color-coded duplex ultrasonography to find out whether the perfusion status of the liver tumor permits a differential diagnosis. A total of 108 patients with liver tumors were included, and the results of color-coded duplex sonography were compared with histology, MRI and CT. No correlation was seen between the final diagnosis and the perfusion pattern. The vascular status visualized by color-coded duplex ultrasonography does not permit differentiation between benign and malignant liver tumors.
Subject(s)
Carcinoma, Hepatocellular/diagnostic imaging , Hemangioma/diagnostic imaging , Liver Neoplasms/diagnostic imaging , Neoplasm Staging/methods , Adolescent , Adult , Aged , Aged, 80 and over , Carcinoma, Hepatocellular/blood supply , Carcinoma, Hepatocellular/secondary , Child , Child, Preschool , Female , Hemangioma/blood supply , Hemangioma/secondary , Humans , Infant , Liver Neoplasms/blood supply , Liver Neoplasms/secondary , Male , Middle Aged , UltrasonographyABSTRACT
A short survey is given about the current developing methods of endosonography and their potential use in tumor diagnosis. Own results are presented in preoperative staging of rectal cancer with endorectal ultrasound.
Subject(s)
Digestive System Neoplasms/diagnosis , Ultrasonography/trends , Digestive System Neoplasms/pathology , Endoscopy/methods , Endoscopy/trends , Humans , Neoplasm Staging , Ultrasonography/methodsABSTRACT
Between 1982 and 1987 we carried out a prospective randomized study to compare the effectiveness of high-dose half-body irradiation (HBI) (A), intensive combined chemotherapy (B), and local or locoregional radiotherapy (C) in the therapy of extended small cell lung carcinoma (SCLC). 99 patients with a histologically proved SCLC were assigned to the three therapeutic groups of series: A = 31 patients, B = 37 patients, C = 31 patients. The median survival period showed a statistically significant advantage (p less than 0.01) for the chemotherapy group (B = 46 weeks) versus the two radiotherapy groups (A = 19 weeks, C = 23 weeks). The survival after half a year, one year, and two years also gave a clear advantage for the chemotherapy group. No difference was found between the radiotherapy groups A and C. The high-dose HBI gave no improvement of the sad therapeutic situation for the extended SCLC.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Bronchogenic/therapy , Carcinoma, Small Cell/therapy , Lung Neoplasms/therapy , Radiotherapy/methods , Carcinoma, Bronchogenic/mortality , Carcinoma, Small Cell/mortality , Female , Humans , Lung Neoplasms/mortality , Male , Middle Aged , Randomized Controlled Trials as Topic , Survival RateABSTRACT
In 30 patients with rectal carcinoma the accuracy of computed tomography (CT) and endosonography (ES) was compared with the surgical specimen. Three cases were overstaged by ES and 4 cases were understaged by CT. The accuracy of ES was 84% and of CT only 76%. Both methods had advantages and limitations. An accurate staging of lymph node metastases was possible neither by ES nor by CT. - We advocate endosonography as the first imaging examination after proctoscopy. CT is recommended in endosonographic doubtful findings and in tight stenoses.
Subject(s)
Adenocarcinoma/pathology , Rectal Neoplasms/pathology , Tomography, X-Ray Computed , Ultrasonography , Adenocarcinoma/diagnosis , Female , Humans , Male , Neoplasm Staging , Preoperative Care , Rectal Neoplasms/diagnosis , Rectum/pathologyABSTRACT
Computed tomography was performed in 27 patients with confirmed malignant fibrous histiocytoma of the soft tissue. Compared with the CT results obtained in other tumours of the soft tissues. CT accuracy in malignant fibrous histiocytoma was only 74%. Non-typical attenuation values, diffuse tumour growth and non-typical contrast enhancement are discussed as reasons for the diagnostic understaging or overstaging of these soft tissue tumours. A higher accuracy was found on ultrasound examination with regard to tumour extension. Bone destruction was better visualised by CT. A base-line CT is recommended postoperatively for the earlier detection of recurrent tumours in further investigations.
Subject(s)
Histiocytoma, Benign Fibrous/diagnostic imaging , Soft Tissue Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Adult , Female , Histiocytoma, Benign Fibrous/diagnosis , Humans , Male , Middle Aged , Soft Tissue Neoplasms/diagnosis , UltrasonographyABSTRACT
Ultrasound guided fine needle biopsy led in 92 of 100 patients with suspected tumours to correct diagnostic results which determined the diagnostic and therapeutic management. Ultrasound-tomography may thus in connection with fine needle biopsy enlarge and simplify tumour diagnosis.
Subject(s)
Biopsy, Needle/methods , Neoplasms/pathology , Ultrasonography , HumansABSTRACT
The further development of modern therapeutical procedures in the treatment of soft tissue tumors requires an improvement of radiological diagnostics. The diagnostic values of X-rays, angiography, sonography and computed tomography is estimated critically. The results of own CT examinations in 120 patients with soft tissue tumors and of 50 ultrasound examinations show the importance of these methods in the extent diagnosis of soft tissue tumors. Ultrasound or CT- guided biopsy are helpful to prove the definitive diagnosis. These methods have reduced the use of angiography.
Subject(s)
Soft Tissue Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Adolescent , Adult , Aged , Angiography , Child , Female , Humans , Male , Middle Aged , Muscles/diagnostic imaging , UltrasonographyABSTRACT
Intermittent positive pressure breathing combined with therapeutic aerosol inhalation (IPPB/I) was applied to improve the preoperative respiratory function and to prevent postoperative pulmonary complications in patients with carcinoma. No significant improvement in ventilation, arterial PO2, and load-carrying could be shown after prophylactical application of IPPB/I for 7 days. A distinct decrease of arterial PO2 was seen immediately after IPPB/I. Further investigations are necessary to improve the method.
Subject(s)
Aerosols , Intermittent Positive-Pressure Breathing , Lung Neoplasms/surgery , Positive-Pressure Respiration , Postoperative Complications/prevention & control , Respiratory Therapy/methods , Adolescent , Adult , Aged , Carbon Dioxide/blood , Female , Humans , Lung Volume Measurements , Male , Middle Aged , Oxygen/blood , Pneumonia/prevention & control , Pulmonary Atelectasis/prevention & control , Respiratory Insufficiency/prevention & controlABSTRACT
The present paper describes the therapeutic use of IPPB/I in postoperative pulmonary complications with ventilation disturbances of the lung. The beneficial effects of IPPB/I are shown in chest X-rays. The suppositions for performing IPPB/I, concerning equipment, staff and organization, are explained.
Subject(s)
Aerosols , Intermittent Positive-Pressure Breathing , Positive-Pressure Respiration , Postoperative Complications/therapy , Respiratory Therapy/methods , Adult , Female , Humans , Liver Neoplasms/surgery , Lung Neoplasms/surgery , Middle Aged , Pneumonia/therapy , Pulmonary Atelectasis/therapy , Respiratory Insufficiency/therapy , Tracheal Stenosis/surgeryABSTRACT
Investigations of the leucine aminopeptidase (LAP) and the gamma-glutamyl transpeptidase (gamma-GT) as a dimension for a damage of the liver cells under ethanol infusion did not show any damage of the liver parenchyma with a slow infusion velocity and a limited ethanol quantity (25 g daily). Since especially in the postoperative phase a sufficient caloric nutrition improves the therapeutic results, one could make use of the possibility of ethanol supply. This is mainly recommendable for patients who should demand only a small infusion volume or such a one which should not carry a high quantity of sugar (for instance diabetics). The parenteral ethanol application in the postoperative phase is frequently indicated for the immobilisation of alcoholics.
Subject(s)
Ethanol/pharmacology , Liver/drug effects , Parenteral Nutrition , Adult , Aged , Energy Intake , Ethanol/administration & dosage , Female , Humans , Leucyl Aminopeptidase/metabolism , Liver/enzymology , Male , Middle Aged , Postoperative Period , gamma-Glutamyltransferase/metabolismABSTRACT
The lethality of 187 patients with severe carbon monoxide intoxication was investigated in relation to body temperature. 22 per cent of the normothermic, but 36 per cent of hypothermic or hyperthermic patients did not survive the carbon monoxide poisoning. The lethality increases following enhancement of degree and duration of hypothermia. Pretreatment of rats with chlorpromazine producing a decrease of body temperature of 4 degree C induces a small reduction of toxicity after subcutaneous carbon monoxide injection. However, the CO-DL50 decreases from 17 to 11,5 mmol/kg following administration of the same dose of chlorpromazine after carbon monoxide injection. Changes in carboxyhemoglobin levels are consistent with alterations of CO toxicity. On the basis of these results, it appears that it is not advisable to maintain a spontaneous hypothermia during carbon monoxide intoxication.
