[Diffusion tensor imaging (DTI) and its importance for exploration of normal or pathological brain development]. / Diffusion Tensor Imaging (DTI) und seine entwicklungspsychiatrische Bedeutung.

Diffusion tensor MR imaging (DTI) can provide in vivo unique information on integrity of white matter structures (anisotropy) and connectivity (fiber tracking) in the human brain. This is made possible by means of non-invasive MR-based technique. The purpose of this article is to review the method and the current applications of diffusion tensor MR imaging. Studies of the past decade featuring relevant neuropsychiatric disorders as well as disorders in child psychiatry are reviewed. Furthermore, this report offers a summary of DTI-studies in children and adolescents showing alterations in brain or CNS structures including neurological, traumatological and oncological investigations. In particular, it focuses on the importance of this method with respect to exploration of normal and pathological brain development.

[Comparison between transoral microsurgery by CO2 laser and conventional surgical therapy for T2 glottic carcinoma]. / Vergleichende Untersuchung zwischen Lasertherapie und konventionell chirurgischer Therapie des T2-Glottiskarzinoms.

BACKGROUND: Transoral CO2 laser excision of early glottic cancer was first introduced in the 1970s. Since then it has become a serious alternative to surgery with conventional instruments. PATIENTS AND METHODS: Between January 1987 and December 1997, 46 patients with T2 N0 M0 glottic carcinoma have been treated by either transoral laser microsurgery or fronto-lateral partial laryngeal resection with curative intention. Long-term results of both methods were compared after analysation of tumor-localization and recurrence-rate. Evaluation parameters were: incidence of local recurrence and incidence of death due to local recurrence. Other aspects of investigation were hospitalisation-time and treatment related patient morbidity. RESULTS: Analysis of the data of our study shows that local recurrences were 5 % lower in cases of laser surgical tumor resection as opposed to conventional surgery (11 % vs. 16 %). If evaluated in accordance to localization of local recurrence in combination with primary tumor localization, results show that all three recurrent tumors in the group of laser resected patients had a primary in the anterior glottic area; two out of the three recurrences following fronto-lateral laryngeal resection were localized in the mid-third of the vocal cord. Hospital-admittance in laser-resected patients was shorter by one day when compared with the group of conventional surgery (10 vs. 11 days). CONCLUSION: T2-Tumors of the anterior glottic area should preferably be approached by conventional surgery (external approach), particularly when endoscopical visualization is difficult. In contrast, T2-tumors of the medial and posterior glottic area should be resected endolaryngeally with the laser.