[Value of a daylight system for radiographic work].
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Biomedical subjects
Publications and source records attributed to K Mathias.
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Caroli's disease is a rare familial anomaly with circumscribed saccular dilatations of enlarged intrahepatic bile ducts coated by regular or pseudopapillomatous epithelium. The disease may be combined with additional malformations of the extrahepatic biliary tract as well as with medullary sponge kidney. Infection and stone formation are frequent complications. Surgery is indicated if the disease is limited to one love which should be resected or if biliary obstruction in diffuse disease necessitates biliodigestive anastomosis. Antibiotics and CDCA-mediation are essential for symptomatic therapy. We analysed the findings in 40 cases including one own observation.
Calcifications of extremities are frequently encountered in radiological practice. Their etiology, localization and differential diagnosis related to topography, distribution, shape, and dimension of calcifications are discussed. The roentgenological appearance of different diseases is demonstrated by typical radiographs.
Postoperative excretory urography revealed severe complications after kidney stone removal in 17 of 102 patients. In 11 cases stone fragments or remaining stones were detected. The high frequency of prognostically important postoperative alterations justifies the postulation to carry out control urography after every kidney stone operation. Control examinations demonstrate prognostically less important changes which must be known by the radiologist to differentiate them from tumorous or inflammatory processes.
Chest and abdominal films were retrospectively examined in 100 patients with acute pancreatitis excluding cases with pancreatitis concomitant to other diseases. Most frequently we found gastric and duodenal distension, diffuse distension of small bowel loops, localized meteorism of transverse colon as well as left flexure and diffuse colonic distension. The chest-films showed: elevated diaphragm and pleural effusion on the left, pneumonitis, pleuritis and and basal platelike atelectases. Pathologic radiological signs were absent in only 1% of the cases.
The response of cerebrospinal fluid pressure to increased arterial carbon dioxide tension was examined in 5 control dogs and 7 dogs with experimental communicating hydrocephalus. The cerebrospinal fluid pressure in control animals only rose to 35 mm Hg after elevation of the arterial CO2 tension. In dogs with experimental communicating hydrocephalus, however, a significant rise of intracranial pressure to 60 mm Hg can be demonstrated. This is accompained by a marked simultaneous decrease of cerebral perfusion pressure in hydrocephalic animals. Progression of communicating hydrocephalus can be explained as damage to the cerebral tissue by increased intracranial pressure waves and by ischemia due to low cerebral perfusion pressure.
A new catheter system for the dilatation treatment of carotid artery stenoses was developed consisting of a dilatation catheter with a second lumen for simultaneous carotid artery perfusion. This catheter system was efficient in dilating experimental carotid artery stenoses in dogs.
Upside-down spleen is a rare positional anomaly which is an embryonic malformation and not a 'wandering spleen'. It is not a disease, but is important to recognize, lest it be misinterpreted on angiographic, scanning or ultrasound examination.
A new case of idiopathic multicentric osteolysis presenting with cranial malformation and mental retardation is described. The patient could be followed for some years. Differential diagnosis is considered and a classification of osteolytic syndromes attempted.
Therapeutic embolization can achieve occlusion of bleeding vessels, arteriovenous fistulas and tumor feeding arteries. Many different diseases can now be treated by angiographic catheter techniques which required surgical intervention in the past. Various embolic materials were applied to produce transient or permanent vascular occlusions. New materials for embolization will be developed. Indications for embolization treatment of tumors are not definitively established because of insufficient knowledge of tumor biology after embolization.
Arthrography revealed extended meniscus lesions in 68 of 78 patients with popliteal cysts. In the remaining cases mechanical damage or inflammatory diseases of the knee were responsible for cyst genesis. Popliteal cysts should be removed only after causal diagnosis of the underlying chronic relapsing effusion leading to increased joint pressure and cystic dilatation of the often communication submembranous bursa.
The radiological evaluation of knee prostheses has its own criteria. Exact implantation of prosthetic components, correction of axial deviations between femure and tibia, bone density near to the prosthesis, width of the radiolucent zone, and the degree of femoropatellar arthrosis are important features. The analysis of 47 knee prostheses showed a less periarticular soft tissue calcifications than in hip prosthesis. Fracture of palacos is not rare and may lead to intraarticular loose bodie's.
Severe ketoacidosis can be complicated by alveolar and gastric ruptures. A knowledge of the pathophysiological mechanisms which may lead to these threatening clinical pictures enables the radiologist to give useful suggestions in the emergency diagnosis, as shown in the examples of two patients here.
A transvenous catheter technique for renal puncture is described which was successful in 9 of 11 punctures performed in 8 dogs. Macrohematuria was not observed in any case. Autopsy revealed only small subcapsular hematomas. The advantage of this procedure is the reduced risk of bleeding achieved by peripheral puncture and by-passing of the great central vessels with aid of phlebographic controls. Moreover localization of kidneys by excretion urography--impossible in patients with renal insufficiency--is unnecessary.
The position of 2467 intravenous catheters was controlled radiographically over a period of one year. In 22.5% the position needed correcting. In most cases it was sufficient to withdraw the catheter slightly. In 68 patients in whom the catheter had formed loops or had entered the jugular vein the position was corrected using a J-shaped guide wire and was successful in 63 cases. This method needs little time and equipment and saves the patients repeated venous punctures. Not including bacterial contamination of the catheter the complication rate of venous catheterisation was 2.6%.
Amongst 434 transfemoral cerebral catheter angiograms a success rate of 98.16% was achieved. The catheters and manipulations required for successful catheterisation are described. In view of the screening time required, a comparison with needle angiography was made. It was found that catheter angiography was better in all cases in which several cerebral arteries had to be demonstrated.
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Different morphological and functional causes of the vertebrobasilar artery insufficiency, which were found in the examination of 128 patients, were analyzed and compared with well known syndromes. Possible misinterpretation in evaluation of angiograms are emphasized.