[Intraoperative ultrasound of the pancreas in hyperinsulinism]. / Intraoperative Sonographie des Pankreas beim Hyperinsulinismus.

In four cases of hyperinsulinism proven clinically and by blood chemistry the value of intraoperative sonography of the pancreas is emphasized. An insulinoma could be localized preoperatively in two patients. In one of these two cases intraoperative sonography detected additional insulinomas. In the remaining two patients the negative preoperative examinations and surgical palpation was confirmed by using this method: diffuse islet cell hyperplasia was the final diagnosis in both cases.

[Excretory urography: comparison of the ionic contrast medium amidotrezoic acid with the non-ionic contrast medium iohexol]. / Ausscheidungsurographie: Vergleich des ionischen Kontrastmittels Amidotrizoesäure mit dem nichtionischen Kontrastmittel Iohexol.

The contrast media diatrizoic acid and iohexol were compared in a randomized double-blind study on the basis of 100 excretory urograms. It was found that side effects are less frequent under the non ionic contrast medium than under the ionic agent, the difference being statistically significant at the level alpha = 0.05. No statistically significant difference was recognizable concerning the overall quality of the urograms.

Percutaneous extraction of centrally embolized foreign bodies: a report of 16 cases.

Sixteen cases of centrally embolized foreign bodies are reported (eight catheter fragments, two guide wires, four pacemaker electrodes, one ventriculo-atrial shunt, one Port-A-Cath catheter). In all patients only the Dormia basket was used. Foreign body extraction was successful in all patients except one, in which removal of a pacemaker electrode from the myocardium failed. Technical aspects as well as complications of percutaneous foreign body extraction are discussed.

[Phlegmonous inflammation of the large intestine: a sonographic diagnosis?]. / Phlegmonöse Entzündung des Dickdarms: eine sonographische Diagnose?

Diseases of the gastrointestinal tract accompanied by a thickened bowel wall have become more accessible to ultrasonic detection during the last years. In most of the cases, however, the sonographic pattern has no characteristic feature for any disease. In this paper we present the rare case of a phlegmon of the colon and discuss its differential diagnosis.

[Fibrinolytic therapy of thromboembolic vascular occlusions: primary success rates and long-term results]. / Fibrinolysetherapie thromboembolischer Gefässverschlüsse: primäre Erfolgsrate und Langzeitergebnisse.

A prospective study of the results of fibrinolytic therapy in 87 patients was carried out with particular reference to the type of fibrinolytic agent. The primary success rate using urokinase was 78%, which was markedly greater than the 44% success rate when using streptokinase. An attempt was also made to evaluate the effect of other factors, such as the extent and duration of the occlusion. Long term results, as might have been expected, were directly related to the primary success rate. If fibrinolytic therapy resulted in fairly normal vasculature, the long-term results were satisfactory in 79%, whereas unsatisfactory reconstruction of the vascular bed produced a satisfactory long-term result in only 30%.

Fixed intravascular foreign bodies: a new method for removal.

Percutaneous removal of centrally located, embolized, intravascular foreign bodies is essential. A technique was developed to shift fixed foreign bodies into a position where they may be grasped and eventually removed with a snare or Dormia basket. It involves insertion by bilateral femoral vein puncture of a curved-end catheter and a second catheter attached to a Dormia basket set. A wire passed through the first catheter is grasped with the Dormia basket, and the foreign body is mobilized by means of traction on both catheter systems.

[Arteriovenous fistulas of the lung--their clinical aspects and radiologic images]. / Arteriovenöse Fisteln der Lunge--deren Klinik und radiologisches Erscheinungsbild.

Based on the data of 15 patients the typical radiological signs of pulmonary arteriovenous fistulas, their differential diagnostic implications, clinical signs and symptoms and management are reviewed. In addition, lung function parameters of 9 patients are presented. The critical role of pulmonary angiography and sequential dynamic CT for the diagnosis is stressed, particularly in those cases in which conventional chest radiographs and tomographies fail to show characteristics abnormalities. Since pulmonary arteriovenous fistulas tend to increase in size and cause complications, they should be subjected to intermediate treatment, even if they are of no haemodynamic relevance.

[The thoracic picture in acute traumatic aortic rupture]. / Das Thoraxbild bei der akuten traumatischen Aortenruptur.

We tried to find out the validity of 16 wellknown signs indicating an acute traumatic aortic rupture on plain chest radiographs of 22 patients. Angiographically 11 of all patients had a tear at the aortic isthmus. It turned out that 7 of the 16 signs (widened mediastinum, loss of the aortic knob contour, opacification in the aortopulmonary window, bulging of the vascular pedicle predominantly to the left, left apical cap, depression of the left main stem bronchus and displacement of the right paraspinous interface) are of great diagnostic value.

[Cystic form of meconium peritonitis--a case report]. / Zystische Form der Mekoniumperitonitis--Ein Fallbericht.

In this case report the cystic form of meconium peritonitis is presented. The aetiology and differential diagnosis of this rare entity are discussed.

Olbert dilatation catheter system: complication due to inexpert handling.

A complication of inexpert handling of the Olbert catheter system is presented. The balloon was inflated while the clamp at the proximal end of the catheter was closed. This resulted in kinking of the distal end of the catheter within the balloon. Difficulty in catheter removal resulted but was overcome by an improvised coaxial sheath technique.

[Bronchioalveolar carcinoma]. / Das bronchioalveoläre Karzinom.

A study of 21 patients suffering from bronchioalveolar carcinoma and 1028 comparable cases of the literature is presented. By this we gained statistical data concerning radiological and clinical manifestations of this rare tumour. However, radiological signs estimated to be typical of this carcinoma, like "rabbit ear sign" and positive "air bronchogram" are too rare to be really helpful for putting up the diagnosis. At time of diagnosis the mean age was 58 years. Men are hardly more frequently concerned than women. Smoking seems to have no aetiological significance. The most common clinical symptom was chronic cough followed by chest pain. A large amount of sputum--a symptom which sometimes has been estimated to be typical of this tumour--occurred only very rarely.

[Primary malignant tumors of the pleura]. / Primäre maligne Tumoren der Pleura.

This study represents the examination of 14 primary, malignant pleural tumours--10 mesotheliomas and 4 sarcomas--in respect of the radiological appearance and clinical signs and symptoms. The presentation was widely different in the mesothelioma patients: 3 presented the radiological image of a mantle-like apicocaudal callosity. In 3 patients and extrapulmonary space-occupying growth was seen; one case presented with an interlobar effusion. Pleural effusion was additionally present in 6 cases. Of the 4 sarcoma patients, 3 presented with an intrapulmonary space-occupying growth and one only with an extrapulmonary lesion. Pleural effusion was definitely seen in 2 patients with pleural sarcoma. Therapy-resistant refractory thoracic pain was the principal clinical sign. Other symptoms were not so frequent, such as loss of body weight, tiredness, dyspnoea, hemoptysis and cough.

[Nonvisualization of the gallbladder lumen by sonography]. / Das sonographisch "nicht darstellbare" Gallenblasenlumen.

Out of 12 000 sonographic examinations of the abdomen in 211 cases the gallbladder was not visualized. The retrospective analysis of 41 patients revealed in 75% gallstones, in 15% space occupying lesions (4 carcinomas, 1 abscess, 1 sludge). In 10% the sonography gave a false positive result. The reasons are discussed.