Biomedical subjects
Publications and source records attributed to W Hofner.
Report of the case history of a female patient suffering from malignant mesothelioma of the peritoneum. Exceptional findings were a dense nodular hematogenic dissemination over both lungs and the duration of disease, which till now extends over 35 months. Pathogenesis, course of disease, diagnosis therapy and epicrisis are discussed.
Clinical and pathological studies indicate, that sarcoidosis rarely affects the thyroid gland. The diagnosis of sarcoidosis in the lung and in the thyroid has been established by biopsies taken during surgery in a case of a 53 year old female. The manifestation of thyrotoxicosis in sarcoidosis-involvement of the thyroid has been analysed and compared with the 15 patients exhibiting sarcoidosis-involvement of the thyroid and thyrotoxicosis described in the literature.
The spectrum of intrapulmonary findings of Hodgkin's disease is illustrated by 75 pulmonary episodes of 22 patients with Hodgkin's disease (duration of illness up to 14 years). Both the typical and frequent, as well as the rare pulmonary manifestations are discussed. We analysed the time correlation between pulmonary changes and clinical manifestations, and the effect of therapy. This retrospective investigation showed that more than 55% of the observed 75 pulmonary episodes have been diagnosed correctly by the initial radiological examination. By simultaneous appearance of different forms of disease propagation, sideeffect of therapy and superimposed diseases, diagnosis may be impaired.
One hundred and twenty one Baker cysts demonstrated by arthrography have been analysed. Morphologically one must distinguish between distension cysts and dissection cysts. Distension cysts are more common with various diseases of the knee joint (68% of all cysts). Dissection cysts (32%) are found particularly with inflammatory-rheumatic diseases and are rarely of degenerative or post-traumatic origin. Acute rupture of the cyst was observed on ten occasions. Repeated rupture, which had only been suspected previously, was demonstrated by arthrography in four patients. It is pointed out that Baker cysts may imitate the features of acute thrombophlebitis.
Five cases of an antefemoral synovial cyst in rheumatoid arthritis were confirmed by arthrography. Communicating with the suprapatellar bursa, these rarely observed cysts may be considered an anterior analogy to dissecting Baker cysts.
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Hemodynamic consequences, especially in view of a developing pulmonary hypertension are essential factors regarding the course and prognosis of an obstructive airflow disturbance. The characteristic roentgen symptoms of pulmonary vascular changes in a group of patients are collected and statistically evaluated to find those symptoms correlating best with the results of cardiac catheterisation. The importantce of using not a single symptom but characteristic groups of symptoms for the radiological diagnosis of pulmonary hypertension is stressed. Radiological signs of increased pulmonary pressure do not directly correlate to the degree of direct measurements, false positive radiological reports need not be expected. Positive radiological symptoms indicate irreversible anatomical changes in pulmonary circulation. For the individual patient the pulmonary arterial pressure by cardiac catheterisation alone is not sufficient for the diagnosis and prognosis of this case as in obstructive air-way disturbance two definitely different types of diseases, namely type A (emphysema) and type B (bronchitis) with divergent hemodynamic consequences must be distinguished. For this differentiation the radiological evaluation of the anatomical situation is essential.
Hemodynamic consequences, especially in view of a developing pulmonary hypertension are essential factors regarding the course and prognosis of an obstructive airflow disturbance. The characteristic roentgen symptoms of pulmonary vascular changes in a group of patients are collected and statistically evaluated to find those symptoms correlating best with the results of cardiac catheterisation. The importance of using not a single symptom but characteristic groups of symptoms for the radiological diagnosis of pulmonary hypertension is stressed. Radiological signs of increased pulmonary pressure do not directly correlate to the degree of measurements, false positive radiological reports need not be expected. Positive radiological symptoms indicate irreversible anatomical changes in pulmonary circulation. For the individual patient the pulmonary arterial pressure by cardiac catheterisation alone is not sufficient for the diagnosis and prognosis of this case as in obstructive air-way disturbance two definitely different types of diseases, namely type A (emphysema) and type B (bronchitis) with divergent hemodynamic consequences must be distinguished. For this differentiation the radiological evaluation of the anatomical situation is essential.
Diagnosis of combined malformation of lung and pulmonary vessels are presented in a case of one lobe lung on the right (Agenesis of two lobes and hypoplasia of the presenting lobe). The importance of radioisotope methods in diagnosis of lung hypoplasia is stressed. Pathogenesis and period of teratogenic termination is discussed.
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The evaluation of activity of tuberculous lesions in patients with unknown previous course make an additional tomographic assessment of the lesion necessary. The value of this approach is being illustrated by 8 cases.
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Varicella and primary varicella pneumonia occurred in a patient with advanced Hodgkin's disease. The radiological characteristics are shown. Various relations between varicella, herpes zoster infections and Hodgkin's disease are discussed briefly.
In 4 patients with juvenile idiopathic thoracic scoliosis an atelectasis as part of the convex-sided lungs was found. In all cases there was a small sagittal diameter of the chest; the atelectases were situated in the right lower and middle lobe and caused by the close topographical relation of large bronchi and scoliotic spine (sometimes compression of the bronchus) demonstrable by tomography, bronchoscopy and bronchography. The therapeutic approach of these atelectases is discussed. Thoracic casting either for conservative correction and treatment of scoliosis or as postoperative immobilisation after fusion was done. In all cases, it may influence the occurrence of an atelectasis.
Problems of defining "early diagnosis" and difficulties, arising from multiform clinical and radiological manifestations in bronchial carcinoma are discussed. Different types of manifestations offer unequal chances for early detection. In demonstrating some typical cases, auxiliary diagnostic means and possibilities for more efficient radiological diagnosis are discussed.
Intrapulmonary hematoma caused by blunt trauma to the chest may appear as round opacities of various size. The diagnosis depends on an exact case history and radiological follow up. 4 relevant cases are being presented. The incidence and pathogeneses are being discussed.