[The heart and great vessels].
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Biomedical subjects
Publications and source records attributed to A Teifke.
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Thoracic x-ray examination supplies information that is important in diagnosing heart disorders. The article presents the pathophysiological fundamentals and x-ray morphology criteria for assessing the size of the entire heart and of the individual cavities as well the cardiac functions, in a comprehensive survey.
Dysfunction of the pharyngoesophageal junction is a rare condition and may cause severe signs and symptoms. The underlying abnormality is a dysfunction of the cricopharyngeal muscle. Based on two case reports, the radiological findings are discussed.
Primary mediastinal seminoma is an uncommon lesion and should be included in the differential diagnosis of mediastinal tumors. Symptoms and signs may not be clear and in most cases the diagnosis is made by sternotomy or thoracotomy. Our recommendation is that patients with primary mediastinal seminoma should undergo curative resection or reductive surgery. Curative resection should be followed by radiation therapy. Chemotherapy with cisplatin-containing combinations should be reserved for patients who have metastases at the time of diagnosis.
Eight-three scaphoid pseudo-arthroses were found amongst 1.104 scaphoid examinations. Sixty-seven were present at the first examination and 16 pseudoarthroses developed amongst 252 scaphoid fractures. Men were affected predominantly, particularly in the 20 to 40-year old group. Fractures in the proximal third of the scaphoid and vertical oblique fractures had a particular tendency to pseudo-arthrosis formation. The operative treatment of choice is a Matti-Russe bone graft. Only one patient in seven with definite scaphoid pseudo-arthrosis showed firm fusion.
The extragonadal seminoma rarely manifests as a mediastinal tumour. It is histologically similar to the testicular seminoma and is often combined with other malformations. The tumour produces signs and symptoms due to its space-occupying or infiltrating nature. Radiological methods cannot establish the diagnosis, which is performed by surgery; however, in most of the cases staging is required (thoracotomy). Treatment is possible by surgical excision, irradiation or drug therapy, with an average five-year survival rate of 75%.
In extrahepatic cholestasis it is necessary to include Mirizzi's syndrome in the differential diagnostic considerations. Characteristic findings in sonography and computed tomography are: a stone incorporated in the neck of the gallbladder or cystic duct with an extension of the common hepatic duct above the stone and normal width of the bile duct below the stone; in endoscopic retrograde cholangiography (ERC, direct cholangiography), a characteristic finding is a smooth-walled, segmental stenosis through external compression or an incorporated stone.
The CT image of renal metastases is described for 29 patients. The most frequent primary tumour was the bronchial carcinoma, followed by melanoma and cervical carcinoma. In 12 of 29 patients (41%) the metastases occurred bilaterally, in 17 (59%) unilaterally. 9/29 (31%) had solitary, 20/29 (69%) multiple renal metastases. In 19 (66%) these had a size of up to 3 cm and were situated intraparenchymally. Space-occupying growths up to a size of 10 cm which grew exophytically were seen in melanoma and carcinoma of the larynx and chorion. In the plain CT the metastases presented isodense or slightly hypodense in 25 of 27 examinations (93%). After application of contrast medium all presented hypodense with the exception of metastases of a chorionic carcinoma.
A comparison of the oesophagogram and computed tomography has shown that there is angulation of the axis of the oesophagus in 75% of patients with perioesophageal tumour spread. This angulation is more common due to tumour in the younger patient. Longer tumours tend to show deeper infiltration into the peri-oesophageal tissue, although its frequency is not necessarily increased. Tumours longer than 8 cm. show infiltration in about 80% of cases.