[Clinical value of ultrasonography and computerized tomography prior to abdominal interventions]. / Klinischer Stellenwert von Sonographie und Computertomographie vor abdominellen Eingriffen.

We studied the value of ultrasound and computed tomography in the preoperative diagnosis of abdominal diseases in 100 patients. Reference methods were the reports of surgery and pathology. A computed tomography or ultrasound diagnosis could be correct or false and was considered uncertain, if the main diagnosis was missed but computed tomography or ultrasound suspected pathology, which then could be clarified by other procedures. Overall, computed tomography was superior with 75 correct, 13 false and 12 uncertain diagnoses compared to ultrasound with 58 correct, 31 false and 11 uncertain diagnoses. Ultrasound often failed because obesity or gas impaired visibility. If only cases without technical problems of ultrasound were taken into account, diseases of liver, gallbladder, pancreas, kidney, the adrenal region and other abdominal masses were equally well diagnosed by ultrasound and computed tomography. As expected, the diagnostic value of both modalities was markedly reduced in diseases of the bile duct and the gastrointestinal tract. Because the study design required both, ultrasound and computed tomography, cases already clarified by ultrasound were not included. This fact might have further reduced the sensitivity of ultrasound in comparison to computed tomography. Furthermore, ultrasound was mostly one of the first diagnostic procedures performed right after the patient's admission with little information on anamnestic and clinical data. The information given prior to computed tomography was in general more detailed.

[Embolization by the wall components after the PTA of pelvic arterial stenoses]. / Embolisation von Wandbestandteilen nach PTA von Beckenarterienstenosen.

Quality and frequency of embolisation caused by angioplasty of stenoses of iliac arteries were investigated in 50 patients. In 18% emboli were found. They mostly consisted of atheromatous material and were visible by macroscopic view in 10% of the patients. Complications caused by embolisation during angioplasty of iliac artery stenosis however are very rare.

[Unwanted side-effects in using mesalazine (5-aminosalicylic acid) during radiotherapy]. / Unerwünschte Nebenwirkungen bei Anwendung von Mesalazine (5-Aminosalicylsäure) unter Strahlentherapie.

In a prospective randomized placebo controlled double blind study, the prophylactic effect of mesalazine (5-aminosalicylic acid. 5-ASA) as suppositories (3 x 250 mg/day) on radiation induced proctitis during radiotherapy for prostatic carcinoma was studied. The study ended when 16 patients had been included (5-ASA: eight, placebo: eight) because of severe side effects in the 5-ASA group. 75% of patients treated with 5-ASA reported symptoms of a severe proctitis while only one patient in the placebo group had similar complaints. The application of mesalazine as suppositories is not useful in preventing radiation induced proctitis during radiotherapy of prostate carcinoma.

[The role of radiotherapy in the treatment of granuloma gangraenescens (lethal midline granuloma]. / Die Rolle der Strahlentherapie in der Behandlung des Granuloma gangraenescens (letales Mittellinien-Granulom).

The granuloma gangraenescens in the oral, maxillary and facial region is a rare disease. It is a destroying process in the region of palate, nose, paranasal sinuses, cheeks and orbit with characteristic signs of granulomatosis, infection and malignancy. The disease shows often a lethal development with cachexia or sepsis. Besides local inflammations and tumors, the granulomatosis of Wegener, and the so-called necrotizing sialometaplasia are above all to be excluded by differential diagnosis. Five cases are presented in order to describe the diagnostic and therapeutic problems. In literature, the greatest efficacy is attributed to radiotherapy, however, a detailed definition of the most efficient irradiation conditions cannot be given yet because of the small number of cases. Good long-term results or recoveries can be achieved in 75 to 80% of cases by a relatively high radiation dose of 40 to 50 Gy administered within four to five weeks. During the observation time of two to six years, no one of the five patients treated here only by megavoltage therapy showed a recurrence.

Testosterone metabolism in human bone.

The conversion of [1,2,6,7-3H]testosterone to [3H]dihydrotestosterone has been assessed in ground sp¿ongiosa of normal and osteoporotic bone. The tissue was obtained from 23 patients, 18 women, 3 men and 2 children who were undergoing orthopedic surgery. The formation of dihydrotestosterone was demonstrated in all samples examined. The half maximum rate of dihydrotestosterone formation occurred at a substrate concentration of 0.3 microM a value similar to that reported for dihydrotestosterone formation in other androgen target organs. Under the standardized conditions utilized in this study the rate of dihydrotestosterone formation did not differ significantly in normal as compared to osteoporotic bone. Furthermore, the conversion of testosterone to androstenedione was also similar in osteoporotic and normal bone. Based on these studies it seems reasonable to conclude that dihydrotestosterone rather than testosterone is the active intracellular androgen in human bone since in other androgen target tissue androgen action is mediated by dihydrotestosterone if 5 alpha-reductase is present.