0000000000659008
AUTHOR
T. Schaub
99mTechnetium-Mercaptoacetyltriglycin (MAG3) zum Nachweis von Nierenveränderungen nach extrakorporaler Stoßwellenlithotripsie
Extracorporeal shock wave lithotripsy (ESWL) has become the treatment of choice for urinary calculi. 117 patients were studied prospectively with 99mTc mercaptoacetyltriglycine (MAG3) before and after ESWL. 79 (66%) of the 119 kidneys treated had abnormal findings. Of these 63/119 (53%) had abnormal scans. 41 (65%) had focal lesions with a delayed intrarenal transport. The remaining 22 had a diffuse delay of intrarenal transport. A loss of relative renal function of 3% and more compared to the pretreatment values was observed in 50/119 (42%) patients. 99mTc MAG3 should be done routinely together with radiologic tests (CT or MRI) before and after ESWL to select the patients at risk for post …
Computertomographie nach extrakorporaler Stoßwellenlithotripsie (ESWL) der Nieren
In 105 patients CT studies were done prospectively after renal ESWL with a second generation lithotripter. 33 (31%) of the patients had renal oedema (n = 8), renal (n = 20) or extrarenal (n = 31) bleeding. Three of the 23 patients who had a three year follow-up had chronic renal changes, 10 had renal stones. As blunt renal trauma can be the cause of renal hypertension a longterm follow-up is necessary in ESWL patients, particularly if there was renal bleeding after treatment. Further studies are needed to determine the exact risk of renal hypertension after ESWL.
Stellenwert der Skelettszintigraphie in der Diagnostik und Verlaufskontrolle des Ewing-Sarkoms
The radiological and scintigraphic findings of 26 patients with histologically proven Ewing's sarcoma were analysed. Three-phase bone scan should be done early in patients presenting with pain and normal radiographs. Perfusion and metabolism of a bone lesion can be assessed by skeletal scintigraphy. Bone metastases are first seen on bone scan. In the follow-up of the patient bone scans at regular intervals are essential to detect bone metastases and tumour recurrence. The scintigraphic findings have to be correlated with radiographs and if these are negative a short-term control is indicated. Three-phase bone scans can assess the tumours response to therapy.
Der Einsatz der Tumorprothese bei sekundär-neoplastischer Destruktion des proximalen Femurendes
Total hip arthroplasty was performed with PMMA-augmented tumor prostheses in 42 individuals suffering from metastatic destruction of the proximal end of the femur at the Orthopedic University Hospital Mainz from 1980 to 1992. Neoplastic lesions had been triggered by carcinomas of the breast in 25 female patients. 24 of our patients presented with pathologic fractures. In all patients capable of walking preoperatively early mobilization could be attained by total hip arthroplasty. Pain relief was achieved in each patient. Resection of the major trochanter and, partially, of the pelvitrochanteric muscle sleeve entailed luxation of the prosthesis six times in 5 individuals during the first pos…