[Intra-arterial DSA for control of aortocoronary bypass--an alternative to coronary angiography]. / Intraarterielle DSA zur Kontrolle aortocoronarer Gefässbrücken--eine Alternative zur Coronarangiographie.

Intraarterial DSA is a suitable method for early postoperative control of coronary artery bypass grafts. Small quantities of contrast media with low iodine content are injected into the aortic root. Investigations can be carried out with a routine fluoroscopic and digital equipment; additional cine-technique and analogue memory disc are not necessary. At an image rate of 3/s the bypass anastomoses can be exactly visualized in 75%, whereas diagnostic information was not sufficient in only 4% of all cases. The use of modern F-5-catheters and the nonselective injection make this method a less invasive alternative to coronary angiography. It is particularly useful in evaluation of short- and long-term results.

Present interdisciplinary treatment regimen for advanced head and neck tumours at the West German Tumour Centre, Essen.

Apart from the classic combination of surgery and irradiation, four other treatment modalities are presently being evaluated in advanced head and neck tumours. These are: 1) antineoplastic chemotherapy 2) radiosensitizing agents 3) high LET radiotherapy 4)local hyperthermia Preoperative chemotherapy, followed by surgery and irradiation, has improved the local control as well as survival rates in phase II trials. Cis-platinum may yield some additional benefit due to its radiosensitizing properties. Radiosensitizing drugs such as nitro-imidazoles have so far failed to show any advantage in randomized trials, since neurotoxicity prevented maximum effective concentrations. The same is true for high LET radiotherapy with neutrons as compared to conventional irradiation. Local hyperthermia is considered as a palliation at the present time, when all other treatment modalities have been exhausted. In our centre, the preliminary results of radiotherapy and sensitization with cis-platinum in combination with surgery are encouraging. Some methods are discussed which permit the prediction of prognostic criteria for tumors under treatment. This may contribute to the optimization of individual treatment regimes in the future.

[Experience with titanium mesh as a temporary foreign material implant for the reconstruction of mandibular defects]. / Erfahrungen mit dem Titan-Gitter als temporäres Fremd-implantat zur Wiederherstellung bei Unterkieferdefekten.

Restoration of a loadable mandible after extensive resections, defects or comminuted fractures, serious osteomyelitis and pseudarthrosis will be successful only if sufficiently stable fixation of the fragments and immobilization beyond the physiological period of bone healing are guaranteed. By means of various types of plates and extroral appliances for osteosynthesis the conventional methods have been improved, but failures and complications are still frequent. The treatment itself is a great strain for the patient. The titanium mesh implant system developed by Ph. Boyne and his group for reconstruction in mandibular defects means, in our opinion, an important therapeutical step forward. Its technical advantages and our own clinical experience advocate application of this system.