Biomedical subjects
Publications and source records attributed to K Fochem.
The article reports on the value of the analysis of the histogram in computed tomography in carcinoma of the pancreas. This additional examination possibility is critically reviewed and analysed. Evidently this method is useful as an additional examination method which can throw light on possible malignancy of a process in case of doubt.
n 856 female patients round opacities were found in mammography. In 58 patients of this group the pathological and histological results were known. 125 female patients had been examined more than three times. With these 183 fibroadenomas thus established, criteria were worked out facilitating the decision whether surgical intervention would be required or short-term control could be justified. In comparison with the benign opacities, these histologically confirmed carcinomas were examined according to clinical, thermographical and radiological criteria.
Thermography is a valuable complementary method in breast examination, but is not a suitable screening method. However, the results of control investigations in 200 females who were reexamined after at least two years, showed no change in the thermographic pattern in 87.5% of the women. In 10.5% the change in thermogram was due to pathological changes, whilst no explanation could be found in only 2% of cases. This high stability rate of the thermograms permits an alternative procedure: If, one year after a basic examination which includes clinical investigation, mammography and thermography, the thermographic pattern is identical with the first, no mammography is necessary. On the occasion of the next control, mammography should be carried out again at the time of the subsequent control examination. This schedule permits a reduction in irradiation without reducing the security of diagnosis.
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Imaging of the vault of the cranium via CT must be considered as an additional examination. It is possible to assess the CT image already stored during examination of the brain, without additionally exposing the patient, merely by changing position and breadth of the window. In our opinion, primary indication for CT of the vault of the cranium exists only if diagnosis based on survey remains doubtful. However, examination will always be combined with a representation of the individual strata of the brain. Our studies have also shown that in many cases CT assessment of the vault of the cranium necessarily also involves comparison with the surveys.
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The article reports on a male patient of 72 years of age suffering from rhinoliquorrhoea caused by meningoencephalocele. This disease pattern is in itself very rare, but in the case presented here it assumes a highly unique character by the concomitant clinical picture, namely, a combination with mucocele of the frontal sinus and by the case history (rhinoliquorrhoea without trauma and without meningitis).
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Echography of the breast was performed in 100 women in whom palpation had prompted suspicion of the presence of a cyst. Examination was done with a real-time scanner with a 2.5 or 5 mhz freely mobile soundhead. Cysts were detected in 56 women by this sonographic method. Approximately 9% of these were complicated cysts requiring surgical treatment. Although sonography facilitates identification of, single or of multiple cysts, it will be necessary to perform pneumocystography and x-ray film examination in two projections on first examination in order to exclude complicated cysts, since mere sonographic control after puncture of the cyst is too inaccurate for identifying complicated cysts.
The clinical symptoms and signs of gynaecomastia are reviewed with particular reference to radiological appearance, thermography and therapeutic measures.
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Case report on a case of pelvic lipomatosis, the 21. case published in the world literature. The typical radiographic findings, such as deformity of the urinary bladder and the abnormal course of the sigma, were seen. Computed tomography confirms the diagnosis.
The article reports on sonography of the testicles with a 5 MHz transducer. Attention is drawn to the outstanding image quality even without a water flowpipe. Sonography offers a diagnostically wide scope in diseases of the testicle, varicocele being the only field where thermography continues to be the method of choice.
The exact measurement of the transverse diameters of the bony spinal canal is not yet possible due to the limitations of the CT-systems presently available. Therefore, these measurements have to be made on conventional radiographs.
The problem of possible neonformation of lymphatic nodes following lymphadecetomy was studied by means of computer tography in 45 patients with malignant tumours of the tests and 5 women who had been subjected to radical hysterectomy (Wertheim's operation). In addition, the problem of visualisation of the lymphatic nodes via computer tomography is discussed on the basis of a few examples.
There is no uniform image of the involutional breast. Different mechanisms of involution of the breast lead to variable findings on clinical examination, mammography and thermography. A description is given of common findings since it is necessary to recognise the various physiological forms as prerequisite for their differentiation from pathological findings.
This article emphasises that computer tomography is suitable for disclosing occult destructions in the region of the vertebral column. On the other hand, computer tomography is of great importance for determining the extent of destructions which are already manifest, and any possible spreading of a pathological process in the soft parts to the vertebral column.
The examination shows, that in search for skeletal metastases the bone scintigraphy marks the bone-process in 45% while the X-ray is still silent. Therefore, we believe that the first examination in quest of skeletal metastases must first be a whole-body scintigraphy and then secondly, an X-ray examination with tomography, inasmuch as scintigraphy cannot give an exact differential diagnosis (degeneration, inflammation or destruction).