[Intravenous cholangiocholecystography using ioglycamide--indications and value]. / Intravenöse Cholangiocholezystographie mit Ioglykamid--Indikationen und Wertigkeit.

The introduction of modern methods of diagnostic imaging as sonography, CT and endoscopic retrograde cholangiopancreaticography has changed the value of intravenous cholegraphy. Since the introduction of the contrast medium Ioglycamide into clinical practice two years ago we evaluated the cholangiocholecystographies of 50 patients. The investigation was indicated, if no elucidation was achieved with sonography. Side effects were not registered with Ioglycamide. Indications and value of the method are discussed.

[Comparative ultrasound and computerized tomography studies of lumbar intervertebral disks and the lumbar canal]. / Ultraschall- und computertomographische Vergleichsuntersuchungen lumbaler Bandscheiben und des Lumbalkanals.

Sonography and computerised tomography were carried out on 61 lumbar segments (L5/S1, L4/5, L3/4) of 30 patients not having vertebrogenous symptoms. Transabdominal lumbar sonography with a 3.5 MHz sector probe proved to be a valuable imaging method, allowing to demonstrate the shape and dorsal outline of the lumbar discs. Bowl-shaped, right-angled and funnel-shaped configurations of the dorsal spinal canal are typical findings. The interpretation of the ultrasonic tomograms and the identification of normal anatomy are improved through comparative imaging by computerised tomography.

[Radiation dosage of premature infants caused by roentgen imaging of the thorax]. / Strahlenbelastung Frühgeborener durch Röntgenaufnahmen des Thorax.

The X-ray pictures of the thorax from premature infants must be prepared by conditions of neonatal intensive care. For this X-ray pictures are available very often single-puls generators only. The radiation exposure is dependent prominently on the type of the generator. The radiation exposure was compared between single-puls generators and 6-puls generators. The dosimetry was performed with CaF2-thermoluminescent dosimeters. The results of measurement demonstrated: In the radiation fields the radiation exposure is considerable higher by the single-puls generators than by the 6-puls generators. The indication to X-ray pictures of the thorax from premature infants under conditions of bed-side with single-puls generators must be very accuratly.

[Diagnostic strategy in primary malignant bone tumors in children]. / Zur Diagnosestrategie bei primären malignen Knochentumoren im Kindesalter.

Our experience concerning the diagnostic proceeding for primary malignant bone tumours in children and their often difficult differentiation from osteomyelitis are discussed. A retrospective evaluation of patient records of 66 children showed, that in 53 cases (41 with osteomyelitis, 12 malign tumours) diagnosis was immediately obtained from clinical and radiological results. For five more children osteomyelitis was proven by short term monitoring and paraclinical investigations, while in 8 cases final diagnosis required biopsy. CT was relevant for the evaluation of intraosseous and intramedullary extending tumours and mandatory for therapy planning. Conventional radiography, however, remains the most important method within the diagnostic strategy, but the need for close cooperation of radiologists and clinicians and a synoptic evaluation of clinical results, radiography and anamnestic data must be stressed.

[Diagnostic strategy in urolithiasis]. / Diagnosestrategie bei Urolithiasis.

The roentgenological diagnostics of urolithiasis must be carried out with regard to the therapeutic consequences. With the appropriate use of new imaging methods the prevailing techniques are native radiographs and sonography for proof or rejection of suspected renal calculus. Excretion urography is no longer justified as the primary method of investigation. Already practically proven diagnostic schedules are described. Interdisciplinary cooperation of radiologist and urologist is essential for the introduction of diagnostic strategies into practice.

[Value of iopamidol in radiologic diagnosis]. / Der Wert des Iopamidols in der radiologischen Diagnostik.

The effect of the contrast medium Iopamidol/Iopamiro, Bracco (Milano) was studied in 31 patients via intravascular or intraarticular injection, as well as in experiments on dogs with 32 kidneys, employing selective angiography and histological examination. In all cases, we obtained good x-ray films showing plenty of detail, the patient tolerance being good. Blood pressure, pulse rate and UN, SGOT, and SeBi values did not show any significant change. In some cases we noticed a moderate proteinuria. In the animal experiments, the kidneys showed histological changes in two cases only which could be ascribed to the action of the contrast medium; however, even these changes were of a minimal nature and degree, and were reversible. Iopamidol was found to be a very favourable contrast medium as far as the kidneys are concerned.

[Contrast medium elimination by hemodialysis]. / Kontrastmittel-Elimination durch Hämodialyse.

In 6 patients with no apparent kidney function the elimination of contrast medium was examined using 125I-labelled diatrizoic acid. Also blood level time curves and concentrations of dialysate were measured, showing a biexponential fall. The kinetic data established by computer-aided analysis according to the two-compartment model yielded elimination values not achieved by a healthy kidney; however a maximum elimination rate of 80.7 +/- 4.7% of the dose administered was calculated for a dialysis period of more than 10 hours. As the contrast medium plasma level was reduced the efficacy of haemodialysis fell.

[The distribution of the intravascularly applied contrast medium diatrizoate in the cerebrospinal fluid]. / Zur Distribution des intravasal applizierten Kontrastmittels Diatrizoat in den Liquor cerebrospinalis.

The examination of 2 so-called minipigs and 5 patients with respect to the distribution of intravenously applied Diatrizoate into the cerebrospinal fluid yielded the proof of a high blood-cerebrospinal gradient. After the establishment of the relative flow balance about 60 to 120 minutes after the injection, the concentration of the contrast medium in the cerebrospinal fluid reaches 1.0 to 1.5 per cent the blood level. This dose-dependent value is exceeded in case of a disturbed blood-brain barrier. Thus the neurotoxicity of this contrast medium gains special importance.

[Recurrences after surgical treatment of achalasia of the cardia (author's transl)]. / Chirurgische Behandlung des Achalasierezidivs.

We observed 17 cases of so-called recurrences of achalasia of the cardia (10 times after preceding dilatation and 7 times after Heller's operation). For surgical treatment 16 of these patients underwent cardiomyotomy, using the transthoracic approach. In one patient who had cardiomyotomy plus fundoplication at the first operation an oesophago-gastrostomy became necessary. Three quarter of these patients had a satisfactory result when followed up. I case of recurrence the authors recommend to give priority to cardiomyotomy, rather than to dilatation or bougienage.

[Changes in the system of kidney pelvis and calices in bladder neck adenoma]. / Veränderungen des Nierenbeckenkelchystems beim Blasenhalsadenom.

The development of a renal lesion following an adenoma of the vesical neck is one of the most important complications of this disease. For the determination of the frequency of changes of the renal calyces in the adenoma of the vesical neck the findings of 253 patients of the years 1976 and 1977, in whom for the first time such an excrescence was established were evaluated. 135 excretion urogrammes showed changes of the renal pelvis and the renal calyces. The main findings were a narrowing of the renal calyces with spindle-shaped necks of the calyces. The calyces themselves were deformed only in one part of the patients. Urinary stasis and cirrhoses of the kidney were not found. As cause of the narrowed renal calyces in correlation with the clinical and laboratory-clinical findings the chronic pyelonephritis, the latent dehydration of the patient and disturbances of the motility of the urodynamics are discussed. As conclusion of these results the opinion is uttered that all male persons from 45 years, who have clinically healthy kidneys and in whom for any reasons an excretion urography has been performed, and in which evaluation narrowed renal calyces were found, by all means must undergo the examination by an urologist for the exclusion of a disease at the vesical neck.

[Behavior of the renal perfusion resistance during automatic organ preservation]. / Untersuchungen zum Verhalten des renalen Strömungswiderstandes während der maschinellen Organkonservierung.

It is reported on experimental investigations in the preservation of mini pig kidneys. At first the behaviour during the initial hypothermic gravitation perfusion is examined. From the relation of perfusate outflow to the perfusate inflow the perfusion quotient PQ is calculated. It is a measure for the volume storage developing during the perfusion (tissue oedema?) and significantly correlates with the warm dead time. The behaviour of the renal current resistance during the following machine permanent perfusion was examined with the help of KABI-albumin-solution and Collins-solution with 5% dextran M 40, and Collins-solution with 5% dextran M 75. Here was shown that the increase of the current resistance correlates with the preservation time depending on the PQ of the initial perfusion. The result is a typical behaviour for the individual solutions. We are of the opinion that the judgement of the behaviour of the kidneys during the machine perfusion must be seen in connection with the initial perfusion.

[Studies and computer analyses on the kinetics of nephrotropic contrast media in patients with different kidney function]. / Untersuchungen und Computeranalysen zur Kinetik nephrotroper Röntgenkontrastmittel bei Patienten mit unterschiedlicher Nierenfunktion.

The local quantity of the contrast excretion depends on the filtration rate and the plasma level. Since the latter is influenced by dosage and kind of application from this result immediate practical consequences for the excretion urography, for which at present a large dose and the bolus injection are preferred.

[Endometriosis of the small intestine]. / Zur Endometriose des Dünndarms

The isolated endometriosis is a rare sickness whose existence is little thought of although it shows relative specific symptoms. With the aid of literature -- survey and according to personal experience on two patients suffering from isolated endometriosis of ileumregion, were clinical treatments carried out. Surgical and hormonal treatments as well as combination of both, have special indications for this kind of sickness.

[Experimental kidney preservation for 30 hours in Collins' solution: angiographical and isotope nephrographical findings after autotransplantation]. / 30-Stunden-Nierenkonservierung mit Collinslösung im Experiment Gegenüberstellung renovasographischer und isotopennephrographischer Befunde nach Autotransplantationen

In experiment canine kidneys preserved in Collins' solution can be kept vital for 30 hours. Angiography after autotransplantation of these kidneys shows good circulation during the immediate postoperative period. Isotope nephrography reveals reversible damage of tubuli which disappears till the 28th day after operation. This procedure of preservation causes tubular damage but does not impair the parenchymatous blood supply. Tubular regeneration therefore is possible.