[An unusual case of cavernous portal vein transformation]. / Ein ungewöhnlicher Fall einer kavernösen Pfortadertransformation.

This paper reports the case of a 36-year-old patient with extensive cavernous transformation of the portal vein, the omentum, and the stomach due to a portal vein thrombosis in the childhood. The morphology of the cavernous transformation using different imaging modalities is demonstrated; etiology and therapeutic procedures are discussed.

[Involvement of the lungs in neurofibromatosis]. / Lungenbeteiligung bei Neurofibromatose.

Two patients, a 66-year-old man (case 1) and a 55-year-old woman (case 2), had been known (for 40 and 35 years, respectively) to have type 1 neurofibromatosis. Dyspnoea, recently even at rest, had developed in both over the past few years. Both were emaciated (weight 62 kg, height 180 cm; 42 kg, 166 cm, respectively). In both the chest radiography had net-like increased interstitial markings. Computed tomography in case 1 showed largely subpleural small-blister-like changes bilaterally (honeycomb lung), while there were large apical cysts bilaterally in case 2. Lung function tests demonstrated restrictive changes in case 1 (vital capacity 48% of norm, relative one-second capacity 88%) and severe ventilation abnormality in case 2 (vital capacity 42% of norm, relative one-second capacity 47%). Both had marked hypoxaemia even at rest and the walking limit was 200 m in case 1, 40 m in case 2. The pulmonary changes were most likely manifestations of the neurofibromatosis. Symptomatic treatment consisted of long-term oxygen therapy with a portable liquid oxygen system (flow rate: 1-2 l/min at rest and 3-5 l/min on exercise; duration: 24 h/d). This achieved a walking distance without hypoxaemia of 500 and 200 m, respectively, with marked improvement in the patients' condition.

[Radiologic follow-up of the thoracic organs in intensive care patients. The value of the thoracic picture correlated with the clinical and biochemical findings]. / Radiologische Verlaufskontrolle der Thoraxorgane beim Intensivpflegepatienten. Wertigkeit der Thoraxaumfnahme in Korrelation mit klinischen und biochemischen Befunden.

Correlation between chest radiographs and clinical indicators was studied in 212 patients in intensive care. 1. There was good correlation between raised pulmonary artery pressure and radiological signs of left heart insufficiency, but not with the value of central venous pressure. 2. Fever and leukocytosis nearly always precede radiological evidence of pneumonia; their persistence does not necessarily indicate persistent pneumonia. 3. Pneumonias, effusions, atelectases and emboli are more common on the right. 4. More than 70% of central venous catheters were incorrectly placed; most commonly, the catheter was placed too low. Life-threatening complications occurred in 1.3%.

[Endosonography versus computerized tomography in preoperative staging of esophageal cancers]. / Endosonographie versus Computertomographie bei der präoperativen Stadienbeurteilung von Osophaguskarzinomen.

The results of endosonography and computed tomography--using an optimized technique of CT--in preoperative staging of esophageal cancer are compared. In 22 of 40 patients with esophageal tumors a complete passage by the ultrasonic endoscope was possible. Endosonography was superior to CT in the assessment of early stages of esophageal tumors (T1/T2). Out of nine tumors confined to the esophageal wall, eight were classified correctly by endosonography, only five by computed tomography. The results in T3- and T4-carcinomas (13 patients) were comparable for endosonography and computed tomography. Endosonography is of importance in the selection of patients with early stages of cancer, in whom a curative resectability is still possible.

Preoperative detection of intrathoracic tumor spread of esophageal cancer: endosonography versus computed tomography.

The results of endosonography and computed tomography, using an optimized CT technique, have been compared in the preoperative detection of intrathoracic tumor spread of esophageal cancer. In 22/40 patients with esophageal tumors complete passage of the ultrasonic endoscope was possible. Endosonography was superior to CT in the assessment of early stage of esophageal tumor (T1-2). Out of 9 tumors confined to the esophageal wall, 8 were classified correctly by endosonography and only 5 by computed tomography. The results in advanced T3 and T4 tumors (13 patients) were comparable following endosonography and computed tomography. Endosonography is an important means of selecting patients with early-stage cancers in whom a curative resection is still a possibility.

[Differential after care for early detection of recurrence from the radiologic viewpoint]. / Differenzierte Nachsorge zur Rezidiv-Früherkennung aus radiologischer Sicht.

Diagnostic imaging plays only a minor role in the followup of local recurrencies in tumor patients. Patient history, clinical and biochemical findings as well as endoscopy are more important. The diagnosis of lymph node and other metastasis, however, requires imaging procedures. Although metastasis can be diagnosed earlier nowadays, they must still have a macroscopic size to be detected. Accuracy of the diagnostic procedures depends on the chosen "golden standard". The higher the standard, the more unreliable are imaging procedures which depending on tumor type and site of metastasis are reduced to accuracy rates of below 50%.

[Percutaneous removal of a pacemaker electrode]. / Perkutane Entfernung von Schrittmachersonden.

The large number of pace-makers introduced transvenously has resulted in increasing the number of complications, amongst which infections and dislocations are prominent. It is usually necessary to remove the electrode, which can be attempted percutaneously by using a Dormia basket, a loop or forceps. Amongst the complications of this procedure are tears to the myocardium, with the risk of pericardial tamponade, or tears of the tricuspid valve leading to tricuspid insufficiency. Consequently, thoracic surgical intervention should be available if necessary. Four successful procedures are described.