[The validity of selected nuclear medicine imaging procedures (brain, skeletal, and hepatobiliary diagnosis)]. / Validität ausgewählter bildgebender nuklearmedizinischer Untersuchungsverfahren (Hirn-, Skelett, Leber-Gallenwegsdiagnostik).

In a retrospective study we tested several scintigraphic investigations for a total of 2,014 patients. As reference we used the results of biopsy, autopsy or the epicritic final diagnosis before emission, summing all clinical signs as well as the results of additional alternative methods and other imaging methods. Criteria of validity (sensitivity, specificity, diagnostic accuracy) are used in a consistent manner. Brain perfusion scintigraphy detected acute cerebral perfusion disorder with a sensitivity of 0.87, differentiating for reversible and irreversible lesions. Carotid angiography had the same diagnostic validity. Because there is no loss of brain substance, the validity of CT and static brain scintigraphy was lower. Skeletal scintigraphy was highly sensitive for the detection of primary and secondary bone tumours as well as for the detection of inflammations and occult fracture. RHS-scintigraphy of the liver, presently used for tumour and metastasis diagnostics after sonography and CT, had a sensitivity of 0.79. It was more sensitive for detecting inflammatory RHS-liver disease (sensitivity 0.95). Biliary scintigraphy was seen under the surgical aspect only for selected questions. It was sensitive for the detection of biliary cyst disorder and the elucidation of complaints after biliary tract sanitation (sensitivities 0.92 and 0.84) and for the detection of duodenogastric reflux (0.7), but was of limited diagnostic value for the differentiation of hepatocellular and obturation icterus with a sensitivity of 0.5.

[An unusual case of neurinofibroma in the distal part of the duodenum]. / Ungewöhnlicher Krankheitsverlauf eines Neurinofibroms des distalen Duodenums.

A case of a neurinofibroma in the distal part of duodenum is reported by the author. It has caused a so-called blind resection of the stomach by Billroth II-type as the result of not clarified bleeding. But after restoration of the duodenal transit by the procedure reverting into Billroth I-operation there was the possibility of the accurate diagnosis of the origin of bleeding by means of gastroduodenoscopy and X-ray examination by duodenal hypotension and with it the definitive healing.

[On the problem of so-called ulcer in the old age (author's transl)]. / Zum Problem des sogenannten Altersulkus an Magen und Zwölffingerdarm

By our own experiences with 471 stomach resections (gastric ulcers) we have found, that the so-called special situation of ulcer in the old age--from Spang firstly defined--has to be critically discussed. There are three groups of patients: 1. Patients with the so-called old age ulcer. 2. Patients who got their ulcer in early years of life. 3. Patients who are younger than 50 years. We mean there is no existance of a special course of this disease in elderly patients. Only the rate of complications which was most frequently to be found in the first group, differs from the other patients. For the surgeons ulcer operations have the same general problems as to be found in operations due to other reasons by elderly and old patients.