[The pancreatographic effect during pharmacoangiography of the pancreas following the administration of glucagon (author's transl)]. / Der pankreatographische Effekt bei der Pankreasangiographie nach Verabreichung von Glucagon

Angiography before and after the administration of Glucagon was performed in 33 adult patients with symptoms suggesting a pancreatic lesion. Preferently the pancreatographic effect was evaluated. The results were compared with those of the angiography following the administration of Secretin and Tolazoline. The pancreatographic effect was visualized in 70% of the patients examined with Glucagon and the rate of visualization of the effect with Secretin and Tolazoline was 60% and 74.5% respectively. The representation of the small vessels could be enhanced with Glugacon only in 15% for the arteries and in 12.5% for the veins, whereas using Secretin and Tolazoline the improvement raised up to 78% of the cases. -- The pancreatographic effect as an additional sign is useful in the differential diagnosis of the chronic pancreatitis (mottled) and the carcinoma of the pancreas (defect or absence of the effect).-- The superselective technique is recommendable. Using this method an improvement of the pancreatographic effect can be achieved already. In pharmacoangiography Tolazoline gives better results than Glucagon.

[Supra-renal venography in patients with suspected endocrine hypertension (author's transl)]. / Nebennierenvenographie bei Patienten mit Verdacht auf endokrine Hypertonie

In forty patients suspected clinically of having an endocrine cause for hypertension, an adrenal cortical adenoma was confirmed histologically in five. Hyperaldosteronism with enlarged or normal adrenals was demonstrated in three patients. The diagnosis in a further eight patients with an abnormal hormone pattern and/or an abnormal venogram has not yet been confirmed. Adrenal glands show considerable variation in their size, shape and localisation on venography.

[Sonography and pharmacoangiography of the pancreas (author's transl)]. / Sonographie und Pharmakoangiographie des Pankreas.

Real-Time-Sonography and pharmacoangiography with vasodilating drugs was performed in 63 patients with suspected pancreatic disease. Confirmation of the pancreatic lesion could be obtained in 41 cases by the symptomatology, pancreatic function test, autopsy, operation, laparoscopy with fine-needle-biopsy and by the roentgenologic visualization of pancreatic calcifications. Considering the relatively advanced disease of pancreatic carcinoma in our six patients the sonographic diagnosis was correct in all of them and with pharmacoangiography we failed on one case. In chronic pancreatitis correct diagnostic results with pharmacoangiography could be obtained in 8 of 18 cases and with sonography in 14 of 18 patients. In this study sonography showed certain advantages in comparison with angiography, but both methods were complementary and a better result in the differential diagnosis between chronic pancreatitis and pancreatic carcinoma could be achieved.

[Preliminary studies in diagnosis of lesions in paravascular organs with intravascular ultrasound]. / Vorläufige Untersuchungen zur Diagnostik von Läsionen in paravaskulären Organen mit dem intravaskuären Ultraschall.

A new variety of intravascular ultrasound examination,--using mainly ultrasound probes with 12.5 MHz, in a few cases 20 MHz--via the inferior vena cava or the aorta was used to image small lesions in paravascular organs (adrenals, lymph nodes etc.). This is difficult with other diagnostic methods. The examinations were performed during selective blood sampling for hormone determination or during angiography, practically without additional burden for the patient. To demonstrate that this ultrasound method can be successfully used, we obtained an image of a small adenoma of the right adrenal, which in this case was also seen by CT and angiography. In another patient we identified a paracaval lymph node 4 mm in diameter. Another application of this method could be the diagnosis of renal artery stenosis in patients hypersensitive to contrast media. As an example, we demonstrated the difference in diameter of the ostia of the renal arteries of a patient with an anatomic variant on the left side. To improve this method it is recommended to use a 7.5-MHz probe with better beam penetration.

[Pharmacoangiography of the pancreas in cases of chronic pancreatitis and carcinoma of the pancreas (author's transl)]. / Pharmakoangiografische Differentialdiagnostik zwischen chronischer Pankreatitis und Pankreaskarzinom unter besonderer Berücksichtigung des pankreatografischen Effekts.

Pancreatic angiography was performed in 246 patients using various vasodilating drugs. A pancreatographic effect could be found in 79% of all cases; Tolazolin was particularly efficient, since the effect could be found in 91% of the cases receiving the drug. The diagnostic value of different parameters was assessed in patients with chronic pancreatitis and in patients with carcinoma of the pancreas, in particular concerning the presence or absence of the pancreatographic effect, and the structure, width and contours of this organ. Evaluating the pancreatographic effect and vascular changes a correct diagnosis could be obtained in 69% of all cases with chronic pancreatitis and in 78% of all cases with carcinoma of the pancreas. The pancreatographic effect was diagnostically essential in 26% of all cases, and turned out to be rather useful in patients with chronic pancreatitis, whereas its diagnostic value was less in patients with carcinoma. The diagnostic value of angiography can be improved by the superselective technique and by applying the vasodilator Tolazolin, which is well tolerated and gives an excellent pancreatographic effect.

A new applicator for ultrasound mammography.

A new water path device, called applicator, for ultrasound mammography which is more comfortable for the patient, besides providing improved imaging conditions compared to other devices is described.

The pancreatographic effect during pharmacoangiography of the pancreas.

Angiography of the pancreas was performed in 55 patients after the administration of different drugs stimulating the blood flow in the pancreas and the pancreatographic effect in this group was compared with that in a series of 174 celiac angiographies without drugs. With drugs the pancreatographic effect appeared more frequently (74.5 per cent) than without (18.4 per cent). The small pancreatic arteries and veins were better demonstrated with drugs. The pancreatographic effect seems to be of value for the differential diagnosis of chronic pancreatitis and carcinoma of the pancreas.

[Percutaneous punch biopsy of vertebral bodies with Jamshidi's needle (author's transl)]. / Die perkutane Wirbelkörperstanzbiopsie mit der Jamshidi-Biopsienade.

In 24 patients with vertebral body changes which could not be clarified either by x-ray examination or scintigraphy, percutaneous vertebral body punch biopsies were performed between the twelfth thoracic vertebral body and the first sacral vertebral body, using Jamshidi's needle. Findings were malignant in six cases and benign in twelve cases, NAD in six cases. Jamshidi's biopsy needle, which is easy to manipulate, has proved very successful, with a good yield of material. Biopsies were conducted on an outpatient basis. No complications were seen.

[Qualification and quality control in sonography]. / Qualifikations- und Qualitätskontrolle in der Sonographie.

On the basis of guidelines issued by the Kassenärztliche Vereingung Hessen, some criteria for the application of sonographic examinations are presented. Minimal requirements for sonographic equipment in certain specialties are mentioned, and it is pointed out how not only case history and clinical examination but also one's own sonographic evidence are important for a accurate sonographic diagnosis.