Imaging and graphics in medicine: concept of an object-oriented platform for clinical research.

We present a workstation-based research platform with two major components. A turnkey application system provides a functionality kernel for a broad community of clinical users with an interest in digital imaging. A development toolbox allows efficient implementation of research ideas and consistent integration of new applications with the common framework of the turnkey system. The platform is based on an elaborate object class structure describing objects for image processing, computer graphics, study handling and user interface control. Thus expertise of computer scientists familiar with this application domain is brought into the hospital and can be readily used by clinical researchers.

[Determination of epidermal growth factor (EGF) receptors in basal cell carcinomas, squamous cell carcinomas and melanomas]. / Bestimmung des "Epidermal Growth Factor" (EGF)-Rezeptors bei Basaliomen, Stachelzellkarzinomen und Melanomen.

We studied the binding of EGF receptors (EGF-R) in 19 basal cell carcinomas, 8 squamous cell carcinomas, and 9 malignant melanomas. Specific binding of EGF-R was detected in 10 of the basal cell carcinomas, and in all the 8 squamous cell carcinomas. None of the malignant melanomas showed EGF-R binding. A comparative study of the receptor status vs. clinical prognostic data, such as grading and clinical course, did not reveal any significant differences, whereas in ovarian carcinomas, the EGF receptor correlated with the prognosis.

[B-scan ultrasound in dermatology]. / B-Scan-Ultraschall in der Dermatologie.

Using a new polyacrylamide material, ultrasonic B-scanning can now be successfully used to show the upper layers of the skin and its tumors. Examples demonstrate the possibilities of this procedure in daily dermatological diagnostics.

[Lymphomatoid papulosis--pseudolymphoma with uncertain prognosis]. / Lymphomatoide Papulose--Pseudolymphom mit dubiöser Prognose.

On account of its distinct clinical and histological picture, lymphomatoid papulosis (l.p.) is mostly considered an entity. A 70-year-old patient with l.p. is described. Histologically, there were similarities to the granulomatous type of pseudolymphoma. The oral treatment with penicillin for 4 weeks was successful, but we cannot exclude a spontaneous remission.

[Splenectomy and reimplantation of splenic tissue in children]. / Splenektomie und Reimplantation von Milzgewebe im Kindesalter.

161 splenectomies are presented with a morbidity of 14.8% and a total mortality rate of 4.3%. The lethality rate due to severe infections (-3.9%), however, was high and mostly caused by an overwhelming postsplenectomy sepsis, pneumonia or meningitis. 61.5% of the infections were caused by pneumococcus. To drop that high lethality rate after splenectomy we replanted splenic tissue in seven patients. Scintigraphic investigations showed in all cases well vascularised splenic tissue. The immunoglobulins were in a normal range. Howell-Jolly bodies, however, did not disappear in all the patients. From our study as well as from the literature one has to conclude that replanted splenic tissue requires immunologic activity but a reduced capacity for phagocytosis. Therefore, in cases of traumatic injury to the spleen it is necessary to try to preserve as much of the organ as possible either by infrared coagulation, gluing with human fibrinogen or partial splenectomy. If these procedures are impossible a replantation of--50% of the original splenic tissue should be done and several thin homogenised particles replanted intra- or retroperitoneally. Out of that a preoperative vaccination against pneumococcal infection is necessary as well as a postoperative penicillin prophylaxis for about three years.