[Dysphagia after taking an acetaminophen-tablet during oral anticoagulation]. / Dysphagie nach Einnahme einer Paracetamoltablette unter oraler Antikoagulation.

The bezoar is only one example for an urgent indication for endoscopic intervention during oral anticoagulation. Because of the lack of life-threatening indication the endoscopy often is delayed for 1 to 3 days until the International Normalized Ratio (INR) is nearly in normal range. As well as the application of unique guidelines on endoscopy during oral anticoagulation new future oral anticoagulants with lower half-life may help to shorten suffering of patients.

[Adjuvant radiochemotherapy with 5-FU and folinic acid in Dukes stage B and C rectum carcinoma: an interim analysis]. / Adjuvante Radiochemotherapie mit 5-FU und Folsäure beim Rektumkarzinom des Stadiums Dukes B und C: Zwischenanalyse.

In a prospective multi-institutional German adjuvant trial patients with curatively resected rectal cancer (Dukes B or C) were randomly assigned to receive postoperative radiotherapy (50.4 Gy) and either 12 or 6 cycles of 5-fluorouracil and medium-dose folinic acid. Our preliminary results of the interim analysis, based on 206 patients, indicate that this adjuvant therapy is well tolerated by the patients and a prolonged chemotherapy over 12 months has no advantage over 6 months of chemotherapy. The relatively high rate of tumor recurrence (30.7%) after a median follow-up of 29.3 months in this trial emphasizes the need for dose intensification planned for a further trial.

[Ergotism with cerebral complications. Case report and review of the literature]. / Ergotismus mit zerebralen Komplikationen. Fallbericht und Literaturübersicht.

Abuse of ergotamine-containing suppositories was followed by generalized vessel stenoses in a pregnant 29-year-old migraine patient and led to a space-occupying great brain infarction in the area supplied by the right internal carotid artery. Impressive improvement of clinical, computed tomography and ultrasound findings was observed during treatment with nimodipine. The literature about cerebral symptoms of ergotism is reviewed.

[Supine thoracic images with a mobile roentgen unit: comparison between the soft-ray and hard-ray technics]. / Thoraxaufnahmen im Liegen mit fahrbarem Röntgengerät: Vergleich zwischen Weichstrahl- und Hartstrahltechnik.

To compare the influence of kilovoltage on the quality of supine chest roentgenograms obtained with a mobile x-ray unit, we examined the films of 50 patients on whom supine chest radiographs had been taken incidentally within a period of 24 hours both with high and with low-kVp technique. For evaluation of the image quality, a total of 11 criteria were compared and quantitated by 5 observers using a simple score method. The same advantages that have been attributed to the high-kVp technique on upright films were found on the corresponding supine examinations. These films showed a more balanced penetration and greater sharpness than those taken with low-kVp. The wider latitude of the high-kVp technique simplifies the exposure, and fewer repeat takes will therefore be necessary. The diagnostic gain outweights the few disadvantages, which are mostly coupled to the increase in scattered radiation. This, as well as the availability of more powerful and efficient mobile generators, should promote routine application of high-kVp technique for supine chest examinations.