Images in clinical medicine. Infiltration of bone marrow by a signet-ring-cell gastric carcinoma.
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Biomedical subjects
Publications and source records attributed to H Platzbecker.
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With our results we want to demonstrate the usefulness of the presurgical embolization of tumours in areas where the operation of the highly vascularized tumours is very difficult or even impossible. In certain cases of angiomatous lesions, better results can be achieved by means of embolization than by surgery. For a safe and successful intravascular embolization an optimal technique with DSA, an experienced team and a cooperative patient are absolute prerequisites for interventional procedures in head and neck regions. CT in axial and coronal scans are important to outline the lesion, especially the bone destruction in the skull base. In juvenile nasopharyngeal angiofibroma we found the best results of devascularizing the tumour, if we first embolized the maxillary artery. According to Davis we performed a facial artery injection at the end of the embolization, in order to opacify the collateral of the maxillary artery, and thus control the completeness of maxillary artery embolization.
The therapeutic decision in the management of Peyronie's disease depends on the confirmation or exclusion of inflammatory activity. Plain films of the penis in mammographic technique demonstrate the presence of fibrotic or calcified areas, in which conservative treatment is not more effective. In twelve out of 32 patients, we found calcifications of various size.
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As every diagnostics also roentgenological diagnostics of breast carcinoma involves misinterpretations. By exact evaluation technique, profound clinical investigation and profound knowledge of x-ray symptoms errors can be reduced. The close cooperation of referring physician, radiologist and pathologist is an essential for the improvement of the diagnostics of carcinoma. The radiologist must know possible errors exactly to achieve high rates of correct diagnosis. Especially in the evaluation of mammography clinical and pathologic-anatomic knowledge is required besides much experience in image analysis.
In our study therapy induced early and late effects on the breast were investigated with mammography. All patients with breast carcinoma were treated with conserving surgery and then irradiated. Criterium for the evaluation of the changes was a postoperative mammogram for comparison with the found changes. Severe limitations for the diagnosis of tumour recurrence did not result for this form of therapy.
From the comparison of conventional radiography, computed tomography and angiography the diagnostic value of each of these methods is evaluated. Conventional radiography will remain the most significant method for detecting primary skeletal tumours even if magnetic resonance imaging is considered. CT is an important additional method for the evaluation of tumour size, but is disappointing for tumour classification. Bone scintigraphy is the most sensitive method for the differentiation of solitary and multiple tumours. Angiography is not necessary, except for the planning of surgery in certain cases.
Among 27,756 cases with stationary treatment 1,532 patients were found in whom a systemic fibrinolysis therapy was taken into consideration. Under strict attention to indications and contraindications 173 patients were treated with streptokinase. The rate of treatment failures in peripheral arterial obstructions was 46%, in venous thromboses 29%. The lethality of pulmonary embolisms could be decreased significantly, in acute myocardial infarction however, it could not be reduced. In 10% of the cases we observed severe therapeutic complications. The systemic streptokinase therapy is therefore a certainly effective, but also high-risk method of treatment, which must be performed by an experienced physician.
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Deep pelvic venous thrombosis is a severe complication during pregnancy and requires an early diagnosis and an adequate well-timed therapy. 12 pregnant women with thrombosis of deep pelvic veins have been registered ++ over a period of 10 years. Diagnosis was secured with phlebography in 5 of these cases. It is reported about the necessity and the x-ray exposure of the examination. Treatment of choice is the heparin-longtime-therapy 90 per cent of our cases have been cured successfully.
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