[Computer-aided image processing of digital subtraction angiographs of the pelvis-leg region]. / Computergestützte Bildverarbeitung digitaler Subtraktionsangiographien des Becken-Bein-Gebietes.

Within a clinical study on possible regression of arteriosclerotic processes in humans i.v. DSA-images were made and objectively evaluated. For the first time the digital system Densitron 4 was used for this. The image processing nodes of contrast enhancement, gray-scale and color conversion and stenosis evaluation by density sums are demonstrated for two selected cases from 52 intravenous digital subtraction angiographies of the pelvis-leg region. The results show, that digital image processing can enhance information-relevant detail. The preprocessing of densitometric values accounts for the third dimension of the vessel in its morphologic description. Compared with subjective visual evaluation the digital image interpretation facilitates a much higher degree of detectability of small detail located near the vessel walls and a more objective and reproducible evaluation of the degree of stenosis.

[Diagnostic and prognostic significance of so-called rheumatoid vasculitis--2]. / Zur diagnostischen und prognostischen Bedeutung der sog. rheumatoiden Vaskulitis--2. Mitteilung.

51 patients with rheumatoid arthritis and high rheumatoid factors (mean titres 928) underwent examination for the demonstration of an extraarticular organ manifestation within the scope of the cooperation between the Department of Medicine of the Karl-Marx-University Leipzig and the Institute for Rheumatology of the Academy of Medical Sciences of the USSR in Moscow. The frequency of nodous rheumatism (about 60%) is comparable with the frequency of polyneuropathy. In 20% of the patients a systemic muscle atrophy, a hepatomegaly as well as a Raynaud-syndrome were stated. By means of skin biopsy in 28% perivascular infiltrates were found. Altogether in 6 patients (12%) a participation of the lungs and the pleura, respectively, could be proved. Only rarely a clinically manifest heart disease caused by the rheu-we we found an pericardial effusions in 3 cases. In systemic manifestation, such as myositis, participation of the eyes or vasculitis of the digital arteries with necrosis, were only sporadically to be established. Among 22 patients we found an pericardial effusions in 3 cases. In systemic manifestation in most cases increased parameters of activity were found. From the practical point of view apart from increased titers of the rheumatoid titres and circulating immune complexes (C1q-BT) increased concentrations of the C-reactive protein are prognostically significant. The presence of high rheumatoid factor titres alone as well as the isolated presence of rheumatic nodes must not always be connected with an unfavourable prognosis. When severe extraarticular manifestations are present a possibly early, intensive occasionally extracorporeal treatment is indicated.

[Computed tomography as an aid in the differential diagnosis of radiolucent stones and tumors of the upper urinary tract]. / Die Computertomographie als Hilfsmittel bei der Differentialdiagnose nichtschattengebender Konkremente und Tumoren der oberen Harnwege.

The difficult differential diagnosis of urothelial tumors and nonopaque calculi of the upper urinary tract has been considerably improved by the introduction of computed tomography (CT) in urological diagnosis. Nonopaque calculi although urographically not visible can be determined by CT. Usually urothelial tumors can be traced by CT without invasive methods. In case of doubt in addition to the primary scan a so called flow-study, after application of contrast medium, will furnish additional information. The diagnostic facilities provided by CT are illustrated in 18 cases.

[Roentgen examinations of joints in patients with gouty arthritis]. / Die Röntgenuntersuchung der Gelenke bei Patienten mit Arthritis urica.

The radiological examination of the joints affected is necessary for the diagnosis, differential diagnosis and the assessment of the course of the chronic gout. The roentgen-morphological individual symptoms develop depending on the quantity-time-quotient of the precipitation of urates. Frequently apart from degenerative, destructive or osteoplastic symptoms only the signs of a chronic arthritis are an expression of the clinically existing chronic gout. The interpretation of the individual symptoms must be done taking into consideration the total clinical findings. In the primary attack of gout roentgen-morphological alterations at the joints are not to be expected.

[Characteristics of the early phase of ankylosing spondylitis]. / Charakteristik des Frühstadiums der Spondylarthritis ankylosans.

100 patients with several clinical and suspicious radiological symptoms of Bechterev's disease (Institute of Rheumatology Moscow) and 100 patients with the clinical symptoms of Bechterev's disease without radiological symptoms of a sacroiliacal arthritis (Medico-Policlinical Institute Leipzig) have been examined within a common research programme since 1976 and analysed concerning the frequency of the complaints as well as of clinical symptoms at the beginning of the disease. The main complaints at the beginning of Bechterev's disease are nocturnal pains in the lumbosacral region, pains in the joints, in which cases 50% of the patients spoke of swellings of the joints. 42% of the patients complained of the feeling of the morning rigidity in the lumbar spinal column and 22% spoke of increased temperatures. In 9--10% of our patients an iritis was diagnosed at the beginning of the disease.

[Profile and tasks of a medical university polyclinic in the past and present using as example the Medical Polyclinical Institutes of the Karl Marx University of Leipzig]. / Profil und Aufgabenstellung einer Medizinischen Universitätspoliklinik in Vergangenheit und Gegenwart am Beispiel des Medizinisch-Poliklinischen Institutes der Karl-Marx-Universität Leipzig.

After a short survey of the historical development of the Medico-Policlinical Institute of the Karl Marx University Leipzig tasks and developmental tendencies of university medical policlinics are described, evaluating hereby the results of the Vth conference of higher education. They are understood as a university representation of ambulatorily working internists and to a large extent of the specialists for general medicine. Their main tasks consist in education and continued professional training of this group of physicians under integrative description of the whole subject internal medicine, a research oriented to practice as well as a guiding and coordination function for the ambulatory internistic care, taking into particular consideration the early recognition of a disease, in primary and secondary prevention as well as in a scientifically based ambulatory therapy of epidemiologically important diseases.

[Early diagnosis of spondylarthritis ankylopoietica]. / Frühdiagnostik der Spondylarthritis ankylopoetica

For the early recognition of the ankylopoietic spondylarthritis subjective and objective criteria are explained and the importance of X-ray-morphological, cytological, biochemical, immunogenetic and coagulation-physiological investigations are explained. By accentuation of two types of constellation of the course the possibility of an early diagnosis is given still before the appearance of severe irreparable X-ray-morphological changes in about half the cases of disease. Further observations and controls of courses are necessary for the confirmation of evidence.

[Early diagnosis of rheumatoid arthritis]. / Frühdiagnostik der Rheumatoid-Arthritis

On the basis of own observations of courses the author adopts a definite attitude to the early symptomatology of the rheumatoid arthritis. During the first weeks of the rheumatoid arthritis the following symptoms are found: articular syndromes, more frequently in form of obstinate polyarthralgias, mono-oligoarthritis, accompanied by morning rigidity and accelerated BSR as well as impairment of the general condition. In the majority of the patients only the tentative diagnosis rheumatoid arthritis may be made. After a one to three months' course of the disease the diagnosis becomes more probable. It is above all based on constancy and symmetry, characteristic localisation of the articular process, morning rigidity, radiologically paraarticular loosening of the structure and morphological symptoms of an acute and subacute synovialitis. 6 to 12 months after the beginning of the disease a clinical picture forms which allows to make the diagnosis of a certain or classical rheumatoid arthritis in accordance with the criteria of the ARA. The occurrence of a high activity of multiple affection of the joints (permanent symmetrical polyarthritis including the small joints of the hands and feet), distinctive morning rigidity, high fever and much accelerated BSR, beginning with the first weeks of the disease, speaks for the possibility of the development of an arthrovisceral form of the course of rheumatoid arthritis.