[Simultaneous rupture of a patellar tendon and contralateral quadriceps tendon]. / Gleichzeitige Patella- und kontralaterale Quadrizepssehnendurchtrennung.

The simultaneous bilateral rupture of the quadriceps tendon is a rare injury; only occasional reports exist about the bilateral simultaneous rupture of the patellar tendon. Degenerative changes of the tendon due to drugs or diseases lead to the rupture. We describe two cases of simultaneous rupture of the patellar and contralateral quadriceps tendons; only one patient had special risks. We report the management of therapy and the functional results using the Lysholm score and Knee Rating Scale.

[The knee joint--imaging]. / Kniegelenk--Bildgebung.

In the assessment of knee joint abnormalities plain films must still be used today as primary imaging modality. For soft tissue, cartilage, tendon and ligament lesions, sonography, CT and MRI (with arthrography) is available today. Especially MRI leads to a significantly extended diagnosis.

Spondylolysis and spondylolisthesis: correlation with sport.

Spondylolysis and spondylolisthesis occur predominantly in the lower lumbar spine. Besides congenital defects such as predisposition of spondylolysis the correlation between competitive sports activities and an increased incidence of spondylolysis is proved. In early stages, complete healing can be achieved by conservative treatment (abstinence from sports activities for 3 months, orthesis). Persistence of pain, neurologic symptoms and progression of vertebral slipping are indications for operative treatment (reconstruction of the isthmus, dorso-ventral spondylodesis). The exercise tolerance depends on the extent of instability, progression of vertebral slipping and clinical symptoms. The limits of exercise tolerance vary among the individual athletes and require the decision of the physician. Backstroke swimming, abdominal and back muscle strengthening exercises, and types of sport involving smooth movements are advisable. Sports education in school is possible without restriction in patients with stable spondylolysis and in those with spondylolisthesis without unfavourable concomitant factors.

[Spondylolysis and spondylolisthesis and sports]. / Spondylolyse und Spondylolisthesis und Sport.

Spondylolysis and spondylolisthesis occur predominantly in the lower lumbar spine. Besides congenital defects such as predisposition of spondylolysis the correlation between competitive sports activities and an increased incidence of spondylolysis is proved. In early stages, complete healing can be achieved by conservative treatment (abstinence from sports activities for 3 months, orthesis). Persistence of pain, neurologic symptoms and progression of vertebral slipping are indications for operative treatment (reconstruction of the isthmus, dorso-ventral spondylodesis). The exercise tolerance depends on the extent of instability, progression of vertebral slipping and clinical symptoms. The limits of exercise tolerance vary among the individual athletes and require the decision of the physician. Backstroke swimming, abdominal and back muscle strengthening exercises, and types of sport involving smooth movements are advisable. Sports education in school is possible without restriction in patients with stable spondylolysis and in those with spondylolisthesis without unfavourable concomitant factors.

[Lobular carcinoma of the breast in magnetic resonance tomography. A case report]. / Das lobuläre Mammakarzinom in der Kernspintomographie. Ein Fallbeispiel.

The invasive lobular carcinoma of the breast, the incidence of which is 10-15 per cent, occupies a special position in respect of histological differentiation and biological behaviour. No MR signal enhancement was seen after contrast medium application in the tumoral tissue in the case described here, namely, an invasive lobular carcinoma of the breast of 2 cm size. Hence, it is not always possible to exclude with absolute certainty the presence especially of an invasive lobular carcinoma of the breast in the absence of contrast medium uptake.

The value of high-resolution CT-scan for diagnosis of infectious paranasal sinuses disease and endonasal surgery.

Since 1986 the high resolution CT in two planes is part of our preoperative diagnostic program for patients with chronic rhinosinusitis, acute, complicated rhinosinusitis and polyposis nasi. The importance of the CT for diagnosis, localization, and planning the operation shall be demonstrated.

[Computerized tomography as routine examination procedure in the diagnosis of paranasal sinus diseases from the otorhinolaryngologist's viewpoint. Results]. / Die Computertomographie als Standarduntersuchungs-verfahren zur Nasennebenhöhlendiagnostik aus der Sicht des Hals-Nasen-Ohren-Arztes. Ergebnisse.

The renaissance of endonasal microsurgery is not only based on a deeper knowledge of the mucociliar clearance and better operation instruments but depends as well as on the improved radiological diagnosis provided by computed tomography. Since 1986, high-resolution computed tomography in two plains has been part of the authors' preoperative routine diagnostic program for paranasal sinus diseases at their clinic. One hundred and fifty-eight computed tomograms of patients with chronic rhinosinusitis, complicated acute rhinosinusitis, and polyposis nasi were reexamined. The involvement of the paranasal sinuses and abnormalities of the lateral nasal wall were analyzed. The anterior ethmoid is the most frequently affected area in all of the diseases. The computed tomogram is most important for the rhinosurgeon. The ethmoid cell system can be visualized without superimposing structures. Therefore even circumscript pathologic mucosa alterations and the extent of the disease can be defined. All this enables the surgeon to put forward an exact diagnosis and to plan a safe operation as regards important physiological structures of the nose and paranasal sinuses.

[The feasibility of magnetic resonance tomography in the diagnosis of non-palpable breast tumors]. / Möglichkeiten der Magnetresonanztomographie in der Diagnostik nicht palpabler Mammatumoren.

This study deals with the role of MRI in elucidating clinically silent lesions of the breast with indeterminate changes on mammography. MRI localisation of suspected lesions was possible in all cases by using double coils after contrast enhancement of the glandular tissue, independent of the findings on mammography. Inability to demonstrate micro-calcification did not prove a disadvantage. MRI cannot provide a definite tissue diagnosis, since there is overlap between the appearances of malignant and benign lesions.

[Magnetic resonance tomography in the diagnosis of cervix cancer. Computed tomographic and histological correlations]. / Magnetresonanztomographie in der Diagnostik des Kollumkarzinoms. Computertomographische und histologische Korrelation.

The value of magnetic resonance tomography in the diagnosis of carcinoma of the cervix was studied in a prospective series of 20 patients. The results were compared with those of computed tomography and with the clinical findings. The diagnosis depended on the postoperative histology. Gynaecological examination proved superior to imaging methods in determining the extent of local tumour spread. Tumour involvement of the regional lymphatic system was better demonstrated by MRT than by CT. Exact staging proved inadequate with both these methods and the new imaging methods have not produced any changes in operative planning or technique.

[Immunoscintigraphy using 111In-DTPA-labeled monoclonal antibodies: comparison with ECT and planar scintigraphy]. / Immunszintigraphie mit 111In-DTPA-markierten monoklonalen Antikörpern: Vergleich zwischen ECT und planarer Szintigraphie.

The present study was done in order to examine if the use of 111In-DTPA-labeled MAb fragments in place of 131I-labeled MAb fragments increases the sensitivity of tomographic immunoscintigraphy to reach the level of that of planar imaging techniques. In 11 patients with various primary tumors, local recurrences or metastases [colorectal carcinoma (n = 7), ovarian carcinoma (n = 2), papillary thyroid carcinoma (n = 1), undifferentiated carcinoma of the lung (n = 1)], immunoscintigraphy (IS) was carried out using 111In-DTPA-labeled F(ab')2 fragments of various MAbs (anti-CEA, OC 125, anti-hTG) and planar and tomographic imaging were compared intra-individually. By conventional diagnostic procedures, the presence of a tumor mass was confirmed (transmission computer tomography, ultrasound) or verified (131I whole-body scintigraphy, histology) in all cases. Immunoscintigraphy was positive in 9 out of 11 cases by ECT and in 10 out of 11 cases by planar imaging. When using 111In-labeled MAb fragments, intra-individual comparison of ECT and planar imaging resulted in a similar sensitivity. The increased sensitivity of ECT using this tracer in contrast to 131I-labeled MAb fragments may be attributed to the fact that the physical properties of 111In are much more suitable for the gamma cameras most commonly used (single detector, 3/8'' crystal); using 111In-labeled MAb fragments, count rates sufficient for ECT can be obtained within a reasonable acquisition time. This allows to combine IS with the advantages of ECT regarding tumour localization and prevention of artefacts due to superposition of background.

[Problem of pretherapeutic staging of cervical carcinoma. Studies of the diagnostic value of computerized tomography and magnetic resonance tomography in comparison with gynecologic palpation findings and pathologic-anatomic diagnosis]. / Zum Problem des prätherapeutischen Staging des Carcinoma Colli Uteri. Untersuchungen zum diagnostischen Wert der Computertomographie und der Kernspintomographie im Vergleich zum gynäkologischen Palpationsbefund und der pathologisch-anatomischen Diagnose.

In a prospective study of 20 cases, the importance of nuclear magnetic resonance as a diagnostic tool in cervix carcinoma was investigated. The results were compared with those of the Computer tomography as well as with those of the clinical examinations. The histology served as "Standard". In the evaluation of the local tumor invasion the gynecological examination appeared to be the most important. The involvement of regional lymph nodes was detected more accurately by the NMR as compared to CT. The exact clinical staging was not achieved by either method; thus these new diagnostic methods do not alter the planning and the technique of the operation.

[Computed tomography of lung contusion. An experimental study]. / Computertomographie der Lungenkontusion. Eine experimentelle Studie.

A new experimental model has been developed to determine whether computed tomography has any advantages for the investigation of lung contusions. In 27 dogs, chest wall deformation was produced at speeds varying from 17.3 m/sec to 45.7 m/sec, leading to lung contusion. After the injury, 27 out of 27 (100%) CT examinations demonstrated the contusions, but only nine out of 24 (37.5%) were seen on conventional radiographs. In contrast to conventional radiography, which either failed to show the presence of a contusion, or which under-estimated the extent by more than one cm, in more than half the cases CT agreed with the pathological findings in more than 90%. No lung contusions were found at autopsy which had not been demonstrated by CT.

[Computed tomography, magnetic resonance tomography and echocardiography in hypertrophic cardiomyopathy]. / Computertomographie, Magnetresonanztomographie und Echokardiographie bei der hypertrophen Kardiomyopathie.

The value of echo-cardiography, CT and magnetic resonance tomography was evaluated in 10 patients with hypertrophic cardiomyopathy. Echocardiography made the diagnosis in most cases. The diagnostic criteria depended on functional and morphological changes. CT and magnetic resonance can show thickening in the myocardium, either symmetrical or asymmetrical. Magnetic resonance tomography provides excellent demonstration of the myocardium and accurate delineation of the degree of hypertrophy. It is well suited for measuring cardiac wall thickness.

[Current status of scintigraphic diagnosis in liver diseases]. / Zum aktuellen Stand der szintigraphischen Diagnostik bei Lebererkrankungen.

The methods and the radioisotopes used in scintiscanning of the liver have recently seen major advances. The clinical indications for scintigraphy in focal and diffuse diseases of the liver are discussed. Scintigraphy compares favorably with other imaging techniques with regard to sensitivity and specificity.

Pitfall in the CT diagnosis of pulmonary arteriovenous malformation.

A peripheral adenosquamous carcinoma of the right lung with atypical rich vascularization of the central scar was misinterpreted as an arteriovenous malformation based on a chest X-ray examination and a dynamic computed tomographic study.

Comparative study of quantitating 99mTc-EHDP uptake in sacroiliac scintigraphy.

Quantitative sacroiliac (SI) scintigraphy was performed 3 h after an i.v. injection of 16 mCi 99mTc-EHDP. The resulting images were recorded and processed and on an ON data system 150. Five technical approaches for objective digital assessment of abnormal uptake of the tracer at the sacroiliac joints were employed. SI indexes from the ratio of radioactivity in the SI joints and in the os sacrum, determined either by a region-of-interest technique or by a profile-scan technique measuring the maxima of the curve over a defined base line, proved to be the best parameters in discriminating normal from abnormal uptake of the radiotracer in the SI joints. The quantitative scan technique appears to be useful as an objective tool in interpreting SI scans.

[Retrograde pancreatic phlebography with simultaneous balloon occlusion of portal and arterial flow. An experimental study (author's transl)]. / Retrograde Pankreasphlebographie bei simultaner portaler und arterieller Ballonokklusion--Eine experimentelle Studie.

The possibility of demonstrating the venous system of the entire pancreas by retrograde portal contrast injection with simultaneous balloon occlusion of the portal vein, coeliac axis and superior mesenteric artery was investigated in 12 dogs. In seven cases good filling of the larger pancreatic veins was obtained. Portal and arterial pressure relationships altered considerably during various experimental conditions. A rise in serum transaminases was observed only once when there was thrombosis of the portal vein and branches of the hepatic veins. Apart from this, there was no rise in transaminases or alphaamylase. Histologically there were only minor changes in the liver after total occlusion of 40 minutes, the occlusion having been performed over periods of six minutes with two to five minutes of flow alternating. The application of this method to man is discussed.