Biomedical subjects
Publications and source records attributed to W Zaunbauer.
The computer tomographic appearances of carcinoma of the pancreas as seen in 75 patients are described. This radiological method provides conclusive diagnostic information; differential diagnostic aspects in the diagnosis of pancreatic carcinomas are discussed.
Superselective embolization of renal hemorrhage of benign etiology proves to be an effective method with rare complications and low morbidity, which allows to stop the bleeding in almost all of the cases. Two of our own cases are compared to 24 in the literature; and the results are discussed. This type of embolization is indicated mainly in cases with surgically uncontrollable renal hemorrhage and rarely as an alternative to surgical intervention.
The clinical and roentgenographic findings in two patients with posterior fossa extra-axial cysts are presented, a detailed analysis of the angiographic findings of this congenital retrocerebellar leptomeningeal malformations reported and their differential diagnosis discussed.
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Biliary excretion of iotroxamat (ITX) and ioglycamide (IGL) in cholecystectomized dogs fitted with a Thomas duodenal cannula is compatible with saturation kinetics exhibiting maximal excretory velocities of 2.23 +/- SD 0.18 and 1.22 +/- 0.19 mumol/min/kg, respectively. While biliary excretion of ITX obeyed classical Michaelis Menten kinetics, the data obtained with IGL suggested a more complex process. The choleretic effects of both contrast agents (23.6 +/- SD 2.29 and 25.8 +/- 2.21 microliter of excreted substance) were comparable. On the basis of these results and in view of the similar toxicity of the two contrast agents in animals, it may be expected that ITX will have advantages over IGL for intravenous cholangiography.
The radiological features of congenital choledochal cysts are discussed with reference to three cases seen by the authors. The diagnostic problems are mentioned, and use of scintigraphy and ultrasound tomography at an early stage is recommended in order to define more clearly the indications for invasive radiological methods.
The radiological morphology of indirect rupture of the diaphragm is described; this may be followed by transdiaphragmatic prolapse of viscera, possibly complicated by strangulation or incarceration. The differential diagnosis is discussed with reference to fifteen cases seen by the author(s).
The radiological appearances of fibro-epithelial polyps of the ureter are demonstrated by four cases and the differential diagnosis is discussed. These mesenchymal tumors are characterised by their variable position and change in shape during the course of a retrograde pyelogram; they appear as smooth intraluminal filling defects with a narrow base and occasionally a racemose pattern. In general, they do not cause ureteric obstruction--and are more common on the left and in the proximal ureter.
Percutaneous biopsy of the pancreas with a fine needle aimed by ultrasound was carried out on 26 patients with sonographically proven carcinoma of the pancreas. The accuracy of this method was correlated with other radiological techniques. Needle biopsy of the pancreas proved an informative and economical procedure, since the sonographic demonstration of a pancreatic mass otherwise requires additional radiological and endoscopic investigations.
The results of a percutaneous radiotherapy of 136 patients with bladder carcinomas who were treated between 1966 and 1972 are presented in a retrospective study. Before the beginning of the treatment, the diagnosis of these patients had been verified by a lympho-cavo-urography. 21% of the patients had a pathological lymphogram and 40% a pathological urogram. The survival time of patients with normal and those with pathological lympho-cavo-urography showed a difference which was statistically significant (p less than 0.001). There was no patient with inhibited urinary defluxion and demonstrated lymph node metastases who lived longer than 21 months after the treatment. Exclusive percutaneous radiotherapy and primary total cystectomy cannot be considered as curative therapeutic methods. If metastases in the lymph nodes of the regio iliaca communis and paraaortal are demonstrated by lymphography, the prognosis is unfavourable and only palliative methods are justified.
Transcatheter therapeutic arterial embolization with Spongostan was performed in 10 patients with inoperable malignant tumors of the urinary tract. It resulted in prompt and to some extent permanent relief and/or reduction of local tumor symptoms. Despite frequent transient side effects following occlusion, no permanent or serious complications have been directly attributable to the embolization.
Between 1972 and 1975, exploratory laparotomies were carried out on 52 otherwise untreated patients with histologically verified Hodgkin's disease in stages I, II and III following lymphography. 84% of patients with negative lymphograms had histologically normal lymph nodes. 16% of negative lymphograms were shown to have to have histologically positive lymph nodes. Two out of eight patients diagnosed as positive on lymphography (25%) proved to be false positives caused by extensive lymph node involution. The diagnostic accuracy lymphography was therefore 83%. Surgical exploration was of value only in histologically positive cases. Post-operative control by means of lymphanigiography is essential for the evaluation of the course of Hodgkin's disease.
In 33 patients with malignant teratoid testicular tumours, the retro-peritoneal lymph nodes were surgically removed after lymphograms had been carried out. Histological examination of the lymph nodes showed retroperitoneal metastases in 42% (14 out of 33). In 25 of the 33 patients, there was agreement between lymphography and histology; diagnostic accuracy of lymphography was about 76%. In the presence of positive findings, accuracy was 87%.5%, for negative findings it was 72%. The more frequent false negative findings are due to anatomically determined failure of contrast filling of aortic lymph nodes; the less common false positive findings are produced by involution of lymph nodes.
Thyroid function was studied for 42 days in 58 patients, 28 of whome had euthyroid goiter, after urography (diatrizoic acid), cholangiography (ioglycamic acid), and cholecystography (Naiopanoate). After urography and cholangiography short-lived increases of the serum thyroxine occurred in a few patients, but the mean thyroxine and triiodothyronine concentration did not change. By contrast, 7 days after oral cholecystography serum thyroxine had risen consistently by 22% with a concomittant rise of the free thyroxine, while triiodothyronine declined by 15%. The thyroxine metabolite 3,3',5'-triiodo-1-thyronine (reverse T3) rose by 50% and serum thyrotropin concentration doubled. After 42 days thryoxine and triiodothyronine had returned to baseline, and none of the 58 patients developed clinical hyperthyroidism. In patients with severe myxoedema kept on a constant replacement dose with 1-thyroxine NA-iopanoate produced similar changes with the exception of the rise of the serum thyroxine. The primary event after Na-iopanoate seems to be a fall of the serum triiodothyronine, which in turn augments thyrotropin and indirectly thyroxine secretion. the marked and sometimes sustained rose of serum thyroxine after cholecystography may lead to the erroneous diagnosis of hyperthyroidism.
The authors described what they believe to be a more objective method for evaluation of sensation within the digital pulp. It requires the use of electronic equipment including EEG to record the evoked potentials. With further refinement this method should become a valid tool in the objective examination of sensory patterns.
Two cases of a cord trans-section syndrome resulting from contrast damage to the spinal medulla were observed amongst 4,000 abdominal angiograms (0.05%). The anatomical basis, causes and means for avoiding this serious complication of abdominal catheter angiography, are discussed.
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