Biomedical subjects
Publications and source records attributed to E Deimer.
With increased formation of lymph the lymphatic vessels of the liver are detectable on X-ray and can be assessed. Lymphatic vessels of the portal areas and Glisson's capsule and the pathways of the efferent extrahepatic lymphatics are described. Examples of pathological hepatograms in cirrhosis are presented.
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X-ray examination of the stomach sometimes shows a saddle-like impression of the region of the fundus. This phenomenon is without any clinical importance, but there are many diseases such as hiatal hernia, benign and malignant tumours, inflammatory diseases, and varices which are localised at the fundus. Differential diagnostic problems are discussed.
The act of swallowing, which can be analysed by means of radiologically well-discernible phases, is described and placed in anatomic correlation. Several items are of essential importance for regular swallowing: the ability to close the lips, the isthmus faucium, epipharynx and epiglottis and also the action of the lingual punch and the involuntary phase of the act of swallowing induced thereby. During the first phase--the voluntary oral phase--the bolus is prepared for swallowing and the oral cavity is separated from the oropharyngx by the closed isthmus faucium. In the second--the oropharyngeal phase--the involuntary part of the act of swallowing is triggered and the entrance to the nasopharynx is closed. The bolus gets pressed into the oropharynx. During the last, the pharyngo-oesophageal phase, the bolus enters the cranial part of the oesophagus, while crossing the respiratory tract. This step is secured by several mechanisms against the danger of aspiration. Evidence for the occurrence of physiological aerophagia is supplied.
On-target and hence successful treatment can be effected only if the diagnosis of a lesion of the meniscus is established beyond doubt. In the present study the authors tested retrospectively the significance of arthrography for the assessment of a meniscus lesion, basing their evaluation on the surgical findings, and examined the diagnostic problems involved in internal lesions of the knee, following knee surgery. The study utilized the results of 279 cases of double-contrast arthrography; 76 of these patients were operated upon. Complete agreement between arthrography and surgical findings was obtained in 73.5% of the patients. This figure increases to 81.5% when we disregard insignificant diagnostic factors. No complications were seen in any of the outpatient examinations.
The radiological evaluation of the thymus is discussed and the results of 159 pneumomediastinums are described. Amongst these patients, 28.5% had a persistent thymus, 41.1% showed partial involution of the thymus, 22.5% showed total involution and in 7.9% a thymoma was found. Comparison of patients with myasthenia gravis with a group suffering from autoimmune diseases showed a similar incidence of abnormal thymuses. The value of radiology in assessing the need for thymectomy as a treatment is stressed.
The transhepatic method for occluding bleeding oesophageal varices described by Lunderquist and Vang has been carried out in eight patients. The technique, success rate and complications are discussed. In two patients attempt at thrombosis was unsuccessful. One patient suffered a fatal complication. Recurrent bleeding occurred from four days to four months. Bearing in mind the efficiency of the method, its risk, compared with other palliative measures, is acceptable.
Various diseases which can be associated with hemorrhages are located in the esophagogastral transitional region. Emergency endoscopy can contribute significantly to the detection of an acute source of hemorrhage. Roentgenologic examination can make significant contributions toward the further clarification of acute and especially chronic hemorrhages, by assessment of the topographic, morphologic, functional and angiologic conditions. The relevant diseases in this respect are discussed with regard to clinical pattern and significance of the roentgenologic and endoscopic methods of examination, namely, reflux disease, hiatal hernia, cardial tumors, esophageal varices and Mallory-Weiss syndrome. Differential diagnostic problems are demonstrated by means of relevant cases. Brief reference is also made to "operated cardia" and the associated possibility of hemorrhage.
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Report of 2 siblings, aged 12 1/2 and 9 years, with congenital hepatic fibrosis and polycystic disease of the kidneys. Hepatosplenomegaly had been noted in both children at birth. The younger child had suffered from oliguria aged 2 1/2 years. At diagnosis both children had low platelet counts, one also had leucopenia. The cystic disease of the kidneys was verified by angiography. Coeliacography and splenopartography were diagnostically irrelevant. The diagnosis only became apparent from liver biopsy which was performed during splenectomy. After splenectomy there was an increase of platelets, white blood cells and the clotting factors II, V and X. The three years follow-up showed a constancy of renal impairment and of the minor oesophageal varices observed in the one patient who did not have a spontaneous spleno-renal anastomosis. So far no bleeding has been observed. Porto caval anastomosis was omitted in both children. Pros and cons are being discussed.
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On hand of a few selected cases diagnostic and differential diagnostic problems of the cardia are discussed. Radiological and endoscopical values are presented.
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