Accuracy of simple approaches to assessing liver volume in radiological imaging.

OBJECTIVES: The purpose of the study was to evaluate the accuracy of measured diameters and calculated volume indices for determining liver size and to derive a simple approach for estimating liver volume. METHODS: Three hundred twenty-nine volunteers (cohort A) were grouped according to liver volume: small (n = 109), medium (n = 110), and large (n = 110). True liver volume was determined by magnetic resonance imaging (MRI) using manual segmentation. Maximum diameters (maxdiam) of the liver and distances in midclavicular line (MCL) were measured. Volume indices were calculated as a simple product of the measured diameters. The calculated volume indices were calibrated to predict true liver volume. Performance of the calibrated method was evaluated in a control group (cohort B) including randomly selected volunteers (n = 110) and a patient group with histopathologically proven parenchymal liver diseases (n = 28). RESULTS: In cohort A, there was strong correlation between diameters and true liver volume (r s = 0.631-0.823). Calculated volume indices had slightly better correlation (maxdiam r s = 0.903, MCL r s = 0.920). A calibration index was calculated from the volumes and diameters determined in cohort A. Application of this calibration on cohort B verified a very strong correlation between calibrated volume indices and true liver volume (maxdiam r s = 0.920, MCL r s = 0.909). In addition, the low mean difference between predicted liver volume (maxdiam = -70.9 cm(3);MCL = -88.4 cm(3)) and true liver volume confirms that the calibrated method allows accurate assessment of liver volume. CONCLUSIONS: Both simple diameters and volume indices allow estimating liver size. A simple calibration formula enables prediction of true liver volume without significant expense.

Topical therapy of allergic rhinitis in childhood: Allergodil nasal spray--non-sedating in children.

The efficacy and safety of the nasally administered drug Allergodil in the treatment of allergic rhinitis were evaluated in a prospective drug monitoring programme conducted in Germany. Data from 489 children under the age 13 were included. The study was designed to gain knowledge about Allergodil in a normal clinical setting. Dosing was at the judgement of the investigator bearing in mind data sheet recommendations, i.e. one spray-puff (0.14 mg) per nostril twice daily. Patients were treated for four weeks. The occurrence of ten nasal, eye and throat symptoms was rated (0 = never, 1 = sometimes, 2 = often). All symptoms showed a statistically significant improvement at the final visit, as did the overall sums of the scores. These changes were clinically significant. Overall assessment of efficacy by the physicians and the patients was very good and good in more than 85% of patients. 70% of patients required no concomitant medication. 13.5% of patients experienced adverse events, mostly mild or moderate in severity. Safety and tolerance were assessed as very good and good in more than 97% of cases. No sedation was seen. With respect to both efficacy and safety, there were no differences between patients younger than 6 years and those aged 6-12 years. In conclusion, these results suggest that Allergodil is an effective treatment of the symptoms of allergic rhinitis in children. The subgroup of 48 young patients studied shows that Allergodil was safe and well tolerated in patients aged 2-6 years.

[Differential diagnosis of idiopathic facial paralysis: Bannwarth meningopolyradiculitis]. / Zur Differentialdiagnose der idiopathischen Facialisparese: Meningopolyradikulitis Bannwarth.

Lymphocytic meningopolyradiculitis (Bannwarths' syndrome) is a tick-borne Borrelia infection of man. About 60 per cent of such patients exhibit a peripheral facial paresis whose characteristics are clinically not distinguishable from Bell's paresis. Of major importance for the diagnosis, besides the radicular pain that nearly always prevails, are particularly further motoric deficits, a previous erythema migrans and remembered thick bites. A tentative diagnosis can be verified by liquor examination which reveals a characteristic pattern of protein distribution and lymphocytic pleocytosis. Penicillin in high doses is the therapy of choice.

[Prognostic value of the TNM classification and histology of malignant parotid tumors]. / Uber die prognostische Wertigkeit von TNM-Klassifizierungen und Histologie maligner Parotistumoren.

There is no generally accepted TNM-classification of parotid cancer. Three suggestions for such a classification were tested with regard to their prognostic value, using our own cases. The results were compared with the prognostic value of 4 histologically defined tumour groups.