[Magnetic resonance tomography of the postoperative lumbar spine. A comparison of the MR versus CT images in recurrent intervertebral disk prolapse]. / Kernspintomographie der operierten Lendenwirbelsäule. Bildvergleich MR versus CT bei Bandscheibenrezidiven.

In the present study, 40 patients who had undergone disc surgery were examined by high resolution CT and MR for possible recurrence of the disc prolapse and the results are compared. It appears that high resolution spinal MR, using its various tissue parameters provides no new insights into possible recurrence of a disc prolapse. As is the case with CT, the investigator must also evaluate other morphological and clinical factors. In spite of this, MR can be useful in the investigation of abnormal spines.

[Pituitary adenomata. Status of diagnosis and therapy (author's transl)]. / Hypophysen-adenome. Stand der Diagnostik und Therapie.

The advances in pituitary surgery are based on the diagnosis of neuroendocrinological function and the microsurgical operative technique with the help of which pituitary adenomata are approached by the transsphenoidal route in approximately 90% of cases and transcranially in about 10%. On the one hand, hormone-active microadenomata can presently be detected in good time endocrinologically and 80-90% can be removed selectively while retaining the pituitary. On the other hand, it can be shown that the greater the tumor the more frequently hormone excesses persist after the operation. Tumors can be directly visualized in the cranial computer tomogram if they ar not smaller than 5-7 mm. Also, larger extrasellar remains of tumors left after operation can be demonstrated by computer tomography. Larger suprasellar adenomata produce a chiasma syndrome which improves in 80% of patients after transphenoidal operation. The slight operative risk is shown in a total of 737 operations for pituitary adenomata in the last 11 years.

Alpha-L-fucosidase as a serum marker of hepatocellular carcinoma in southern African blacks.

The purpose of this study was to compare alpha-L-fucosidase and alpha-fetoprotein as serum markers of hepatocellular carcinoma in 72 southern African blacks with this tumour and 64 matched patients with benign hepatic diseases which might be mistaken clinically for hepatocellular carcinoma. Alpha-L-fucosidase activity was assayed using p-nitrophenyl-L-fucopyranoside (pNpf) as a substrate and alpha-fetoprotein concentrations were measured by radioimmunoassay. Serum alpha-L-fucosidase activity in the patients with hepatocellular carcinoma (mean 1,268, s.e.m. +/- 83.7, median 1,150 and range 38-3,698 nmol pNpf ml-1 h-1) was significantly higher than that in the matched controls (mean 798, s.e.m. +/- 65.8, median 648 and range 273-3,825 nmol pNpf ml-1 h-1) (P = 0.0001). However, alpha-L-fucosidase was both less sensitive (75 versus 87%) and less specific (70 versus 87%) than alpha-fetoprotein as a serum marker of hepatocellular carcinoma. When, in an endeavour to eliminate false-positive results, the diagnostic cut-off level for alpha-L-fucosidase was increased to 1,500 nmol pNpf ml-1 h-1 and for alpha-fetoprotein to 400 ng ml-1, the sensitivity of alpha-L-fucosidase fell to 21% whereas that of alpha-fetoprotein remained satisfactory at 78%. If the two markers were used together, the number of false-negative alpha-fetoprotein results was reduced from 13 to 5.5%. We conclude that alpha-L-fucosidase is less useful than alpha-fetoprotein as a single marker of hepatocellular carcinoma in southern African blacks. However, the two markers can profitably be used together.