[CT-guided interventions in diseases of the small pelvis following rectal resection]. / CT vezérelt beavatkozások a rectum resectióját követö kismedencei elváltozásokban.

60% of relapses of rectal cancer after abdominoperineal resection occurs at the site of the surgical intervention. Early detection of these recurrent tumours is vital. Among the up-to-date imaging systems CT is the most sensitive method in diagnosis of pelvic tumours. Despite the accurate imaging diagnosis the nature of lesions remains sometimes ambiguous. 11 CT guided biopsies and 2 punctures were performed because of suspected local recurrence or abscess. As a result of biopsies, local recurrence was histologically proven in 6 cases, fibrosis in 4, inflammatory disease in 1. Both punctures revealed the cytological diagnosis of abscess. There were no complications. The interventions were carried out in prone position through the greater sciatic foramen. In the knowledge of the exact anatomy of this region, the procedure can be performed safely by CT guidance and a correct diagnosis can be achieved.

[Pre-hospital fibrinolytic therapy of patients with acute myocardial infarction]. / Akut myocardialis infarctusban szenvedö betegek helyszínen megkezdett fibrinolitikus kezelése.

The authors began prehospital fibrinolytical treatment at the place (at home, at working place, etc.) in 50 patients with acute cardiac infarction in Szombathely, between November 1986 and April 1993. Half of them suffered anterior infarction, the other part of them had posterior lesion. The average time between the first complaints and starting fibrinolysis was 1.68 hours. The treatment has been qualified efficacious in case of having at least two of the following signs indirectly showing early restarted reperfusion: reperfusional arrhythmia, fast ECG-regression, typical enzyme changes. Thirty-seven of 50 patients demonstrated these requirements. Time up to beginning of fibrinolysis was shorter in patients treated successfully. No haemorrhagic complications were observed in the acute period. Ventricular fibrillation under prehospital fibrinolytical treatment presented in 3 patients--all of them were defibrillated successfully. Increasing availability of this treatment can be waited in extension of this therapeutic modality.

[Percutaneous gallbladder puncture and drainage]. / Perkután epehólyag-punkció és -drenázs.

The authors present their experience and results of 88 percutaneous cholecystostomies performed on 72 high-risk patients suffering from acute cholecystitis during the last 11 years. The local and general treatment resulted in total recovery in 24 cases, surgery could be abandoned. In 37 patients the improvement of their general condition made elective cholecystectomy possible. In 4 cases urgent operation became necessary because of reappearance of acute symptoms after a temporary relief. 7 patients died during the acute phase. In 51 patients out of all cases treated with long-term drainage, the gallbladder was washed out with cooled saline 2-3 times daily.

[Percutaneous sclerotherapy of thyroid cysts]. / A pajzsmirigycysták percutan sclerotisatiója.

The authors have performed percutaneous ethanol sclerotherapy in 9 patients suffering from thyroid cysts causing physical and cosmetic complaints during the last 4 years. All cysts proved to be benign by US and aspiration cytology. The sclerotherapy resulted in definitive recovery in 8 cases. No complications of the procedure were noticed.

[Successful surgical treatment of ruptured left ventricular aneurysm]. / Rupturált bal kamra aneurysma sikeresen operált esete.

Authors report on the successful surgical treatment of a ruptured left ventricular aneurysm that resulted in cardiogenic shock. Pathogenesis and complications of left ventricular aneurysm as well as the diagnostic and treatment modalities are summarized. Authors emphasize that the quick and close co-operation between their departments was a prerequisite of the success.

Forehead SpO2 monitoring compared to finger SpO2 recording in emergency transport.

Continuous peripheral oxygen saturation monitoring using a finger pulse oximeter is standard in prehospital emergency medicine. Forehead peripheral oxygen saturation monitoring has been enhanced for better performance during movement and in cold ambient temperatures, both of which are common during emergency transport. We compared a new forehead monitor with standard finger pulse oximeter. The forehead technique had significantly fewer mean (SD) alarms per patient (3.0 (2.2)) than the finger pulse oximeter (7.8 (4.0)) and shorter durations of malfunction (76 (60) s compared to 333 (170) s) when using the finger pulse oximeter. We conclude that measuring peripheral oxygen saturation monitoring with a forehead sensor provides better monitoring quality in emergency care.