Biomedical subjects
Publications and source records attributed to J Lissner.
The introduction of quality control in Diagnostic Radiology needs several steps: (a) the examination of technical parameters, which have influence on picture quality, (b) the judgement of routine plain films, (c) the judgement of the reports, and (d) finally the judgement of the indication.
Sole irradiation treatment for renal carcinoma or its metastases has to be regarded as only a palliative therapy, whereas postoperative radiation therapy brings about a distinct diminution of the frequency of local recurrences, and, at least in advanced tumor stages, an improvement of the 5-year survival rate. Long-term preirradiation (ca 3000 rd TD within 3 weeks, and operation after another three weeks) or short-term pre-irradiation (ca 1200 to 2000 rd TD within 2 or 4 days, and operation the next day) are tolerated well and do involve no disturbances of the wound healing. Surgical treatment is not complicated by short-term irradiation, but often is easier following long-term irradiation; beyond this, the latter may just render possible a radical extirpation of the renal tumor. It appears from first results that decrease of distant spread and improvement of recovery rates in advanced tumor stages may be within reach, particularly in connection with post-operative irradiation.
The report deals with one year's experience of two new 30 cm. image intensifiers with special reference to a 100 mm. film technique. Attention was paid to its applicability to routine work and the usefulness of this format when demonstrated to a large audience. Comparative dose measurements using the image intensifier and a direct film technique are given. The running costs have been analysed. Suggestions for further improving the technique using this format are given.
Short reference is made to the problem of preparing the colon for x-ray examination when colitis is suspected. The optimal roentgenologic examination technique of the colon is demonstrated. This technique requires: multiple large survey films (35 by 43 cm) of the colon - filled with barium and post evacuation; the focal film distance should be at least 150 cm; in addition, double contrast studies with air as well as spot films of the entire rectal and sigmoid area to prevent overlapping of bowel loops. The diagnostic and technical failures of colonoscopy are pointed out but its value as a supplementary examination is emphasized and recognized.
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119 kidneys demonstrating changes consistent with renal tuberculosis were studied in a total of 94 patients by means of selective, transfemoral renal antiography. In the first stage of the disease, this method detected parenchymal involvement which could not be visualized by excretory urography. In stage II the arcuate arteries and occasionally the intralobular arteries, showed typical changes. Cavitation, pathognomonic for the presence of renal tuberculosis were found in 39.3% of these cases. In 40% of the cases the angiographic findingd were more extensive than the apparent findings of excretory urography. Angiography, thus, can render valuable information pertaining to the course of the disease and the necessity of operative intervention. Stage III was usually characterized by extensive changes specific for parenchymal destruction. Typical vascular lesions were readily recognized. Cavitation was found in 86.5% of these cases. Tortuosity and dilatation of the renal pelvis- and/or ureter-arteries revealed evidence of ureteral involvement (stage III2). In the presence of a non-functioning kidney angiography is mandatory to rule out renal aplasia and to differentiate between a kidney destroyed by other disease processes and the complete cavitary destruction of end-stage renal tuberculosis (stage III3).
The routine therapy of metastasizing mammary carcinoma at the present time is reported. The course of the treatment is considered in every case in connection with the mental problems of the patient which are partly caused by the often drastic treatment measures carried out. The methods of local radiation therapy, which is combined with ablative hormonal methods or, in cases of progressive metastasization, with added exogenous hormones, estrogens, androgens or anabolics, is explained in detail. The final part of the paper is devoted to the currently used polychemotherapy which replaces the hormonal methods in progressive metastasization.
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Already few hours after artificial occlusion of the thoracic duct of dogs different communications appear between the lymphatic and the venous system: 1. Lymphovenous communications in the cervical area leading to the right venous angle. 2. Lymphovenous communications at heart level leading to the right venous angle. These lymphovenous communications seem to be preformed anastomoses, which are opened by an increase of the intralymphatic pressure.
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