[Percutaneous transluminal angioplasty in Brescia-Cimino shunt insufficiency]. / Perkutane transluminale Angioplastie bei insuffizientem Brescia-Cimino-Shunt.

Forty-eight patients with failing arteriovenous dialysis fistulas were evaluated in an 18-month period. Forty-six of dialysis access fistulas were of the Brescia-Cimino type; two were fistulas in the upper forearm. PTA was technically feasible in twenty-three patients (44%). 54% dilatations with polyethylene balloons were initially successful and patent at 3 months; 43% were patent at 6 months; and 24% after more than 9 months. Two complications were encountered. PTA is recommended in Brescia-Cimino type dialysis fistulas, as the procedure prevents damage to the arterial and venous vessels suitable for a new fistula at the same forearm. The procedure may be performed on an outpatient basis.

[Radionuclide monitoring of gastrointestinal bleeding activity]. / Radionuklidmonitoring gastrointestinaler Blutungsaktivität.

Radionuclide monitoring was done in 50 patients to assess gastrointestinal bleeding, activity and location. Monitoring with 99m-Tc-in vivo-labelled erythrocytes was performed as sequential scintigraphy in increments of 1-2 hours up to 62 hours. 23 patients without active GI bleeding were correctly identified. 27 patients showed pathologic activities in abdominal blood-pool scintigraphy. In 25 patients peristaltic movement of these activities were seen--in each case we correctly diagnosed active GI bleeding. In 2 patients the activity stayed for a longer period in the same location--one patient had a liver hemangioma, the other patient had an aneurysm of the superior mesenteric artery. The great impact of radionuclide monitoring on diagnostic and therapeutic management of gastrointestinal bleeding is emphasized.

[Hepato-biliary sequential scintigraphy-developments, methods and recommendations for its clinical use. Experience in 350 patients with (99m)Tc-Solcoscint-Hepatobida (author's transl)]. / Die hepatobiliäre Sequenz-Szintigraphie-Entwicklung, Methodik und Empfehlungen für die klinische Anwendung.

Hepato-biliary sequential scintigraphy is an isotope method in the diagnosis of liver and biliary disease. The value and accuracy of the diagnostic information depends on the development of high resolution gamma cameras and new radiopharmaceuticals; these are described briefly. Our investigations on 350 patients were carried out (99m)Tc-Soloscint-Hepatobida. A number of clinical examples illustrate the scope and value of the examination; from these the indications can be deduced. Hepto-biliary scintigraphy will not replace proven gastro-enterological and radiological methods of investigation, but may be added to these in order to obtain rapid and reliable information. This will be of assitance both to the physician and the patient in deciding which of the more complex methods should be employed next.

[Diagnostic exploration of biliodigestive anastomoses with isotopes (author's transl)]. / Nuklearmedizinisch-diagnostische Exploration biliodigestiver Anastomosen.

Using the radiopharmaceutical Solcoscint-Hepatobida (99mTc) and a high definition camera, sequential hepato-biliary scans were performed. Twenty-five patients were used to demonstrate the value of the method for the evaluation of biliodigestive anastomoses and for the recognition of post-operative complications. The method can be recommended in combination with radiological procedures or in situations where radiology cannot be used.

[Hepatobiliary sequential-scintigraphy--progress in the evaluation of postcholecystectomy complains (author's transl)]. / Hepatobiliäre Sequenzszintigraphie--Fortschritte in der Abklärung von Rest- und Nachbeschwerden Cholezystektomierter.

The hepatobiliary sequential-scintigraphy is a nuclear diagnostic procedure useful in assessing the function of liver and biliary system. 40 patients with and 20 patients without complains following cholecystectomy were examined. The value of this method in establishing biliary causes for such complains is demonstrated by typical cases. Simplicity and safety in application as well as diagnostic sensitivity should place the method in the first place evaluating postcholecystectomy complains. Succeeding indirect and direct radiologic techniques then may be used systematically with benefit for the patient and physician. Results indicate, that the procedure will be essential as well in evaluation as in analysis of nature and frequency of such complains by its superior presentation of intrahepatic bilestasis and functional mechanisms of the biliary system including the sphincter of Oddi.

[Heatobiliary sequential scintigraphy. Value of this nuclear-medicine-diagnostic technic in the pre- and postoperative stages following hepato-biliary-tract injuries]. / Hepato-biliäre Sequenzszintigraphie. Wertigkeit dieser nuclearmedizinisch-diagnostischen Methode in prä- und postoperativer Phase nach Leber-/Gallengangsverletzungen.

The increase in accidental abdominal trauma with liver injury and the wide spread of invasive gastroenterologic/radiologic procedures with the risk of liver or biliary tract damage necessitate diagnostic methods for detection and postoperative control of such lesions. Diagnostic procedures in acute liver damage are discussed. Hepato-biliary sequential scintigraphy proves reliable in detection of bile leakage into the peritoneal cavity. Because of the sensitivity, the method should be used before radiologic investigations, e.g., in diagnosis of postoperative biliary structures and in the examination of functional behavior of biliodigestive anastomoses. Intrahepatic bile stasis is recognized as the forerunner of cholangitis.

[The functionally defective Roux Y-loop in biliodigestive anastomoses]. / Funktionsgestörte Roux-Y-Schlinge bei biliodigestiven Anastomosen.

In comparison to common radiologic methods hepato-biliary sequential scintigraphy proves superior in the investigation of the choledocho-(hepatico-)jejunostomy Roux-en-Y. The functional behavior of the jejunal-(Roux-en-Y-) loop is demonstrated. After biliary-intestinal anastomoses, 15 healthy patients showed normal dynamic studies with unimpeded bile passage. Hypotonic loops with intrahepatic bile stasis responsible for cholangitis were seen in 2 patients. A strangulation phenomenon on the level of the mesocolon hiatus responsible for upper abdominal pain is demonstrated in one case.

[Sacroiliac distorsion or subluxation--a medically established concept? X-ray diagnosis--bone scintigraphy]. / Sacroiliacale Distorsion bzw. Subluxation--ein medizinisch gefestigter Begriff? Röntgendiagnostik--Knochenszintigraphie.

50 patients with complaints in the region of the sacroiliacal joints and the hip, but negative radiographs following injury to the pelvis were investigated by bone scan. Scintigraphic diagnosis always showed involvement of the pelvis ring other than the apparent fractures. Together with the clinical symptoms scintigraphic findings are interpreted as sacroiliacal strain or subluxation. Additional injuries to the acetabulum and to the lumbosacral joints may be present. The patients' complaints are explained, the injuries are localized and documented.

[Hepato-biliary sequential scintigraphy. A diagnostic possibility for monitoring bile secretion following orthotopic liver transplantation]. / Hepato-biliäre Sequenzszintigraphie. Eine diagnostische Möglichkeit zur Uberprüfung des Galleabflusses nach orthotoper Lebertransplantation.

One often finds complicating diagnostic uncertainties, when evaluating cholestasis in the early postoperative phase as well as in the follow-up of orthotopic liver transplants. One potential complication is the obstruction of the biliary tract caused by various conditions. The diagnostic value of hepatobiliary sequential imaging is demonstrated in there patients. This method is a noninvasive, simple way of investigating the bile flow after orthotopic liver transplantation, and therefore proves a valueable tool among the diagnostic procedures used for differentiation of the cholestasis syndrome.

[Hepato-biliary sequence-scintigraphy in pre- and postoperative upper abdominal diagnosis. Studies on 200 patients using the radiopharmacon 99mTechnetium-Solcoscint-Hepatobida]. / Hepato-biliäre Sequenzszintigraphie in prä- und postoperativer Oberbauchdiagnostik. Untersuchungen an 200 Patienten mit dem Radiopharmakon 99mTechnetium-Solcoscint-Hepatobida.

Hepato-biliary dynamic studies with 99mTc-Solcoscint-Hepatobida are suggested in the pre- and postoperative investigation of patients with possible surgical disease of the biliary tract. The equipment used for the studies was a gamma camera. The diagnostic criteria used were those of blood retention, liver, gall bladder, and biliary tree visualisation. Results from findings in 200 patients are presented to demonstrate the ability of the technique; especially to disclose evidence indicating intra- or extrahepatic causes of cholestasis.

[Use of a new method for the determination of the duodeno- and jejunogastral reflux after gastric surgery]. / Die Anwendung einer neuen Methode zur Bestimmung des duodeno- und jejunogastralen Reflux nach Magenoperationen. Vorläufige Mitteilung.

The use of hepato-biliary sequential scintigraphy with 99mTechnetium as a new method to demonstrate duodenogastric or jejunogastric reflux is described. In contrast to other techniques, the benefit of minimal stress for patients, routine practice, and combined measurement of fasting and postprandial reflux is pointed out. First clinical studies in postoperative patients are presented and it is accentuated, that this technique has a special field of application in gastric surgery.

[Demonstration of complications caused by implantable catheter systems in regional arterial infusion therapy of tumors of the pelvis (bladder cancer). Radiologic and nuclear medicine control possibilities]. / Darstellung komplikativer Situationen bei implantierbarem Kathetersystem zur regionalen arteriellen Infusionstherapie von Tumoren im Becken (Harnblasen-Karzinom). Radiologische und nuklearmedizinische Kontrollmöglichkeiten.

Loco-regional intra-arterial infusion chemotherapy is gaining momentum in modern tumor therapy. Cytostatica are delivered by an implantable system. Because of high tissue toxicity of chemotherapy functioning of the system must be assured and controls should be simple and reliable. The system implanted in 10 pat. with bladder-cancer (p T3 a-b) was checked by radiological and radionuclide diagnostic means before each chemotherapy. Both techniques proved valuable. Good and deficient functions are demonstrated.

[Neoplastic thrombosis from a uterine cancer via the ovarian vein. Venous collateralization via the vasa vasorum in occlusions of the renal vein and the inferior vena cava]. / Geschwulstthrombose eines Uteruskarzinoms über die V. ovarica. Venöse Kollateralisation über vasa vasorum bei Verschluss der V. renalis und der V. cava inf.

Renal vein and inf. vena caval occlusion by neoplastic thrombus mediated by the ovarian vein from an occult uterine carcinoma is an extraordinary diagnosis. The special angiographic feature consists in demonstrating the renal venous drainage via vasa vasorum of the renal vein and inf. vena cava.

[Primary oxalosis in adulthood. Scintigraphic and radiologic documentation of oxalosis nephropathy, oxalosis arthro-/enthesiopathy and oxalosis cardiomyopathy--review of the literature]. / Primäre Oxalose im Erwachsenenalter. Szintigraphische und radiologische Dokumentation der Oxalose-Nephropathie, der Oxalose-Arthro-/Enthesiopathie und der Oxalose-Kardiomyopathie--Literaturübersicht.

Clinical, radiographic and scintigraphic abnormalities in primary oxalosis of a 52 years old female are demonstrated. Severe oxalosis-nephropathy and oxalosis-arthropathy/enthesiopathy are shown. For the first time an intense myocardial uptake of 99 m Tc-HDP and 99 m Tc-MDP is described in connection with oxalosis. It is suggested that in the appropriate clinical setting this pattern may be suggestive of oxalosis-cardiomyopathy. Review of literature.

[Polycistic liver disease. The hepato-biliary sequential scintigraphy in comparison with other diagnostic procedures (author's transl)]. / Polycystische Lebererkrankung - sogenannte cystenleber. Die hepato-biliäre Sequenzszintigraphie im Spektrum diagnostischer Möglichkeiten.

Hepato-biliary sequential scans are a diagnostic nuclear medicine procedure which might be applied widely with new radiopharmaceuticals and high solution gamma cameras. Typical sequential scans of polycystic liver disease (2 cases) are demonstrated for the first time. Valuable diagnostic information is obtained by usage of all technical facilities to differentiate other diseases, for instance mistaken parenchymal liver changes due to cystic renal disease or metastatic liver disease.