Traumatische spino-thorakale Liquorfistel

An�sthesie zur endovaskul�ren Therapie aortaler Aneurysmen Verfahren und perioperative Risiken

Die transvaskulare Plazierung endoluminaler Gefasprothesen mittels interventionell-radiologischer Methoden ist ein neues, minimal invasives Verfahren zur Therapie von Aortenaneurysmen. Wir analysierten retrospektiv die Praktikabilitat verschiedener Anasthesieverfahren, die pathophysiologischen Auswirkungen des Eingriffs und typische Risiken. Bei 19 Patienten mit Aneurysmen der infrarenalen (n=18) oder der thorakalen Aorta (n=1) wurden in 23 Eingriffen aortale Stentprothesen implantiert. Die Eingriffe erfolgten in Allgemeinanasthesie (AA: n=9), in Periduralanasthesie (PDA: n=8) oder Lokalanasthesie (LA: n=6) mit Analgosedierung. Trotz erhohten Uberwachungsaufwands in der Gruppe AA ergaben si…

Intraarterielle präoperative Chemotherapie fortgeschrittener Zervixkarzinome

Three patients suffering from very advanced primary cancers of the cervix uteri (FIGO II B or III B) were treated. By preoperative selective perfusion of both uterine arteries, using cis-platinum alone, a distinct reduction of the tumour volume was achieved. This was demonstrated clinically and also by CAT scan and NMR technique. The elevated serum CEA and SCC levels decreased to normal values. The histomorphology of the Wertheim-Meigs specimens revealed no tumour invasion of the initially infiltrated parametria. This treatment modality has been developed to minimise the toxic side effects of the inductive (neo-adjuvant) chemotherapy for cervical cancers.

Das Chlorom (Granulozytäres Sarkom, Myeloblastom) - Klinik und radiologische Diagnostik -

Six cases of granulocytic sarcoma are presented. A mediastinal chloroma and a tumor of the submandibular gland were observed with two patients as single sign of acute myeloic leukaemia. In one patient a chloroma appeared as first manifestation of acute myeloic leukaemia. Two patients exhibited the tumor as first symptom of a blastic crisis of chronic myelogenous leukaemia (femoral bone, lumbar spine). The sixth patient with a myelodyplastic syndrom showed a chloroma of the breast. Various radiological procedures were applied including plain radiography, MRT, CT and mammography. The results are compared with literature. Principles of therapy were supplemented.

Pathologist’s Findings after PTCA (The Mechanism of Angioplasty)

Knowledge of the pathological changes induced by percutaneous transluminal coronary angioplasty (PTCA) is necessary to understand its complications.

99mTc–MAG3–Nierenfunktionsszintigraphie ohne und mit Captopril zur Diagnostik der renovaskulären Hypertonie

In this study, the diagnostic value of renal function scintigraphy performed both without and with ACE inhibition has been evaluated using the new radiopharmaceutical 99mTc-MAG3. In cases of decompensated renal artery stenoses, the typical scan finding with this tubular excreted agent was shown to be a distinct parenchymal nuclide retention in combination with a delayed appearance of the radiotracer in the pelvic system. Using this criterion in 43 patients with suspected renovascular hypertension, sensitivity and specificity were 89 and 88%, respectively. Bilateral positive findings were non-specific; excluding them from the study, specificity increased to 100%. In renal insufficiency, capt…