[A renal function analysis using computed tomography. CT clearance versus 131I-hippuran clearance]. / Eine Nierenfunktionsanalyse durch die Computertomographie. CT-Clearance versus 131Jod-Hippuran-Clearance.

The CT clearance in a number of urological patients (39 patients, 25 with normal renal function) was studied by means of an "area under curve" (AUC) method, using a region of interest. 31 patients were given meglumine ioxithalamate and 8 patients Iopamidol as a contrast medium. Both for total and partial function there was highly significant correlation with isotope clearance with good reproducibility. The difference in the pharmacokinetics of the contrast media affected the absolute clearance values.

[A short infusion or a bolus injection of contrast medium in i.v. urography. Comparative density measurements in the kidney pelvic-caliceal system using sequential computed tomography]. / Kontrastmittel-Kurzinfusion oder -Bolusinjektion bei der i.v. Urographie. Vergleichende Dichtemessungen im Nierenbecken-Kelchsystem mit der Sequenz-Computertomographie.

The rate of contrast injection during i.v. urography may vary considerably (bolus injection or drip infusion). The effect of 5 rates of injection (6, 12, 18, 36 and 72 ml/min) on the contrast density in the renal collecting system was examined over a period of 30 minutes. Measurements showed an inter-individual difference of more than 200% in each group. The intra-individual variations for different rates of injection were very slight; individual concentration in the kidney for a given dose depends only slightly on the rate of injection. There is no statistically significant improvement in contrast values as a result of a bolus injection. The reduced incidence of side effects justifies the use of bolus injections but pressure injections are unnecessary from a diagnostic point view.

[Penile venous outflow occlusion: a comparison of erectile function and cavernosometry before and after percutaneous interventions]. / Penile Abflussvenenokklusion: Vergleich von erektiler Funktion und Kavernosometrie vor und nach perkutanen Eingriffen.

After percutaneous transpenile or retrograde venous occlusion for the treatment of a cavernous leak, the clinical results were correlated with cavernosometric flow measurements in 27 patients. In 15 patients, venous occlusion led to a reduction of the maintenance flow: in patients who showed improvement there was an average reduction of 30 ml/min, in those without improvement or deterioration it averaged 0.3 or 13 ml/min respectively. In 7 patients there was increased flow (up to +21 ml/min). One of these patients showed improved erectile function; the remaining 6 showed no change as was also the case in 5 other patients who had no change in cavernosometric measurements. Our findings suggest a multifactorial cause of the venous leaks.

[Radiologic follow-up of the thoracic organs in intensive care patients. The value of the thoracic picture correlated with the clinical and biochemical findings]. / Radiologische Verlaufskontrolle der Thoraxorgane beim Intensivpflegepatienten. Wertigkeit der Thoraxaumfnahme in Korrelation mit klinischen und biochemischen Befunden.

Correlation between chest radiographs and clinical indicators was studied in 212 patients in intensive care. 1. There was good correlation between raised pulmonary artery pressure and radiological signs of left heart insufficiency, but not with the value of central venous pressure. 2. Fever and leukocytosis nearly always precede radiological evidence of pneumonia; their persistence does not necessarily indicate persistent pneumonia. 3. Pneumonias, effusions, atelectases and emboli are more common on the right. 4. More than 70% of central venous catheters were incorrectly placed; most commonly, the catheter was placed too low. Life-threatening complications occurred in 1.3%.

[Intestinal contrasting in abdominal computed tomography]. / Zur Frage der Darmkontrastierung in der abdominellen Computertomographie.

In 56 patients undergoing abdominal CT the gastrointestinal tract was defined by negative contrast instead of the conventional positive contrast from an iodine containing contrast medium. The contrast material was a 2 1/2% mannitol solution and was used for filling the rectum. Filling of the gastrointestinal tract was of similar quality to that obtained with positive contrast media. The number of artifacts due to high contrast boundaries was slightly greater with the negative contrast than it would have been with positive contrast. Differentiation of the gastrointestinal tract from other abdominal organs was equally good for both methods. The negative contrast method was poor in diagnosing cystic tumours but proved much better than positive contrast for evaluating the wall of the gastrointestinal tract.

[Results of surgical therapy of cervical diverticulum]. / Ergebnisse der operativen Therapie des cervicalen Divertikels.

Eighteen patients with a pharyngoesophageal diverticulum were operated on at the University Department of Surgery, Mainz, between September 1985 and July 1990. Results are based on follow-up studies of 15 patients. Three patients were operated upon less than six months ago. All patients underwent excision of the diverticulum and a cricopharyngeal myotomy. The mean age was 69 (49-84) years and the average follow-up interval was 30 (6-52) months. Twelve of the fifteen patients are free of symptoms concerning the esophagus since the operation. Two patients who died 17 resp. 22 months after the operation were also free of symptoms concerning the esophagus. In all 11 patients who had a barium contrast, swallowing was normal and no recurrence was found. The results show excision of the diverticulum combined with a cricopharyngeal myotomy to be an effective method with low risk for the long-term removal of pharyngoesophageal diverticulum.

[Methodologic procedure in the removal of a knotted intravascular pulmonary artery catheter]. / Methodisches Vorgehen bei der Entfernung intravasal geknoteter Pulmonalarterien-Katheter.

Distal knotting of a pulmonary artery catheter that had been introduced via the subclavian or jugular vein, is a possible complication. To avoid venous dissection in the thoracic or cervical regions, removal via a transfemoral approach should be considered as a feasible alternative. The article report on the extraction of two knotted pulmonary artery catheters, effected transfemorally.

[Dose and time dependency of "CT clearance"]. / Die Dosis- und Zeitabhängigkeit der "CT-Clearance".

The contrast medium dose used in CT renal function analysis corresponds to about 1 ml/kg body weight at a measurement interval of 5 or 10 minutes. In the present study the dependence of "CT clearance" on dosage and time was examined in 12 healthy subjects. The amount of clearance was directly proportional to the employed contrast medium dose and to the length of the measurement interval. On account of the superior signal-to-noise ratio, the higher dose (1 ml/kg body weight) will continue to be preferred in future. The measurement interval can be limited to 10 minutes.

[Conventional roentgen examination of the lung in fibrosing alveolitis--correlation with histological, clinical and biochemical findings]. / Konventionelle Röntgenuntersuchung der Lunge bei fibrosierender Alveolitis--Korrelation mit histologischen, klinischen und biochemischen Befunden.

QUESTION: Is it possible to draw conclusions on aetiology, histology or clinical course, looking at the different radiomorphologic appearance and its changes in chest x-rays of patients with "fibrosing alveolitis"? MATERIAL AND METHOD: Retrospective correlation of chest x-rays with all relevant clinical and histological data of 33 patients. RESULTS: In all patients typical clinical signs with changes of lung function and typical histological changes were found. There was no strict correlation between single parameters and radiological findings. In the estimation of the clinical course, no correspondence between radiological findings and clinical data was found in only 18% of the parameters. CONCLUSION: The chest x-ray is an objective investigation which clearly shows the course of fibrosing alveolitis beside its undisputed function in diagnosing acute complications like infiltration, effusion or development of pneumothorax.

Percutaneous penile venoablation for treatment of impotence.

Percutaneous penile venoablation with sclerosing agents and coils was performed in 58 patients. Of 104 ablations attempted, 44 of 51 (86%) transpenile, and 46 of 53 (86.7%) retrograde interventions were technically successful. In 40 patients (69%) erectile function improved (intercourse was possible in 21 without additional measures). Initially improved erectile function deteriorated in 24 patients during follow-up (in an average of 6 months); in 15 of these, intercourse was still possible with injection of vasoactive drugs. In 7 patients, repeat venoablation improved erectile function again. Hot contrast medium was slightly superior to sodium morrhuate as a sclerosing agent. In successfully treated patients, the average decrease in venous leakage was 30 ml/min vs 13 ml/min in treatment failures, with considerable overlap between both groups. Only minor complications were observed. We conclude that percutaneous penile venoablation is technically feasible, and safe. Whether the procedure will have a definite role in the treatment of venogenic impotence, however, still has to be determined.