[Value of monoclonal antibodies (PC 10, MIB1, p53 and LeuM 1) for assessing the prognosis of patients with squamous epithelial carcinoma of the larynx after partial laser resection]

An immunohistochemical analysis with monoclonal antibodies against Ki-67 (MIB 1), PCNA (PC10), p53 and Lewis X antigen was performed on 47 squamous carcinomas of the larynx after partial laser resection. Ki-67 index and expression of Lewis X antigen correlated significantly with both tumor recurrence rate and tumor-free interval. A much weaker relationship was found for the expression of proliferating cell nuclear antigen (PCNA), and no correlation existed with p53 expression. In conclusion, examination of Ki-67 and Lewis X antigen is thought to provide useful prognostic information concerning laser-resectable squamous carcinomas of the larynx.

Accelerated split-course radiation and simultaneous chemotherapy in patients with unresectable head and neck-cancer

Forty-nine patients with unresectable squamous cell carcinomas of the head and neck were treated with accelerated radiotherapy (2 x 2.1 Gy/day, day 1-4 in week 1,2,5 and 6, total dose of 67.2 Gy) and simultaneous carboplatin (50 Mg/M2/ treatment day). Mucositis (21% grade 3 and 4, WHO) and leukopenia (40% grade 3 and 8% grade 4, WHO) were the most important side effects but did not limit the treatment schedule. The response rate was: 46.5% CR (20 pts), 46.5% PR (20 pts), 5% NC (2 pts) and 2% PD (1 pt). After three years overall survival was 35% (median 14 month) and in complete responders disease-free survival was 52%. Our results indicate that combined accelerated radio-chemotherapy might improve the poor results achieved with conventional radiotherapy or sequential chemo-radiotherapy in this difficult patient population. Further studies are neccessary to clarify whether modified radiotherapy or simultaneous chemotherapy or the combination of both are the reason for the improved treatment results.

[Tuberculosis of the smaller joints]

Eighty-nine patients with tuberculosis of joints in the hands or feet have been examined. There has been a change in the peak incidence from adolescence to adult life. The high number of incorrect diagnoses was remarkable (45% in our own patients). A previous tuberculous infection was found in 40% of the patients. Osteoporosis, or bone atrophy, are important radiological signs for the early diagnosis and follow-up of articular tuberculosis. The later phase is characterised by narrowing of joint spaces. Later still there is destruction of subchondral lamellae and fusion of the carpal and tarsal bones, resulting in changes of shape and position.

[Pulmonary tuberculosis today-revisited (author's transl)]

The diagnosis and differential diagnosis of pulmonary tuberculosis--in spite of its general decline in frequency--remains an important task, even today. There are certain types of opacification which should make one think of TB. A pulmonary nodule--with or without hilar involvement--in an adult may represent primary TB. Postprimary disease is usually located in the first or second lung segment, occasionally also in the sixth. Abnormal findings in the apices are usually tuberculous in origin. Bilateral foci in both upper lobes with similar or identical opacification patterns are especially typical of tuberculosis. Without treatment, there is apico-caudal progression. With tuberculostatic therapy, there usually is rapid regression with relative little scar formation. Residuals of cavities can present as a ring like shadow. Tests for TB-bacteria are usually negative in these cases. Circumscribed older lung lesions in asymptomatic healthy appearing patients mandate supervision of these patients to detect reactivation of the disease, which occurs fairly frequent and to prevent the infection of others.

[The significance of arthrography and arthroscopy in the diagnosis of meniscus injury--a comparative study (author's transl)]

The article reports on 364 double-contrast arthrographics and 185 arthroscopies. The results obtained in 126 patients in whom both arthrography and arthroscopy had been conducted, were compared. It became evident that arthrography is of high informative value in the diagnosis of lesions of the meniscus, so that preference may well be given to this method in non-specific knee-joint complaints where meniscopathy is suspected. Arthroscopies are indicated in cases of clinico-arthrographic doubt. Trial arthrotomy for clarifying doubtful meniscus lesions without previous exploitation of all arthrographic/arthroscopic possibilities is no longer justified and should be abandoned. Arthroscopy is definitely superior to arthrography in the diagnosis of, in particular, cartilage structures, of the synovia and of the retropatellar space. It is here where arthrography has its narrow limitations--now and in the future--for methodical reasons.

[The subphrenic abscess--possibilities and problems of ultrasound diagnosis (author's transl)]

The article reports on 37 patients subjected to sonographic examination because of the clinically suspected diagnosis of a "subphrenic abscess". In 7 of these patients, the diagnosis "subphrenic abscess" was arrived at via sonographic examination, and was confirmed in 6 cases by surgery and in one case by postmortem examination. The importance of ultrasound diagnosis for early identification of the subphrenic abscess is discussed and the high rate of accuracy is underlined. The author emphasises that even discreet x-ray film symptoms should prompt immediate ultrasonic examination.

[Sonography in emergency diagnosis of the abdomen (author's transl)]

The article reports on 150 patients, 86 men and 64 women, aged between 16 and 90 years, who were subjected to sonographic examination directly after they had been admitted as emergency cases. In the group of patients under examination, the clinical disease pattern of acute upper abdominal complaints ranked first, followed (in the rate of incidence) by abdominal trauma and acute metabolic disease. In more than 25 % of the cases the decisive diagnosis was made on the basis of sonography only, so that there was no delay in deciding whether treatment should be initiated or whether the diagnosis required further differentiation. In another over 20 % of the cases ultrasound diagnosis contributed quite substantially towards arriving at the final diagnosis. The number of failures or unsuccessful examinations was about 2 % in each group. The rapid, mobile and risk-free use of sonography is emphasised. The results allow the conclusion that the share of ultrasound in the diagnosis of acutely and severely diseased patients should be increased and that sonography should in fact be placed first and foremost, as far as possible, among the diagnostic tools.

[Roentgenological diagnosis of the functioning of the cervical spine (author's transl)]

Basing on literature and 230 own functional examinations of the cervical spine, the author reports on a roentgenological method which satisfies practical requirements. In patients with degenerative and post-traumatic changes, the extent and localisation of the disorders of function and structure of the vertebrae can be determined by this method, enabling discovery of functional disorders in a large number of patients with clinical cervical spine syndrome. X-ray functional testing is shown to be a necessary complement to conventional x-ray diagnosis and clinical examination.

Early X-ray detection of colonic and rectal tumours in European hamsters

Three groups of European hamster (EH) (Cricetus cricetus L.) were treated subcutaneously every two weeks for life with 1/10 or 1/20 LD50 DMH, while two other groups served as controls. Twelve weeks after commencement of treatment, radiological examinations of the colon and rectum were begun. The double contrast method was used. In this way it was possible to detect the earliest neoplastic alteration to take place in the above sites. This occurred in the 26th treatment week and was diagnosed as an adenocarcinoma. The technique used is simple, as well as being suitable for large numbers of animals. In addition, it allows for early experimental analysis of results in respect to latency period, growth rate, incidence and location of tumours.

[Radiculo-tomography for lumbosacral myelography (author's transl)]

The use of tomography can increase the value of lumbosacral myelography in certain circumstances. Post mortem studies have resulted in standardisation of the examination, which will combine optimal diagnostic information with the least amount of effort and with an acceptable amount of stress on the patient. 110 tomographic examinations were performed amongst 680 lumbosacral myelograms (Dimer X). On the basis of this experience, the value of this procedure is illustrated from various points of view and its indications are discussed.

X-ray enlargement modified for use in experimental animal science

The primary enlarged x-ray image is produced by a reduction of the focal-film-distance to 80 cm at a given focal size of 0-15 mm. The advantages of this technique as compared to conventional x-ray methods are exemplified with x-ray images from the shoulder joint of a European hamster, a pseudoarthrosis in the foreleg of a beagle, and a renovasography of a rat. The principles of the technique and its significance for investigations using small laboratory animals are discussed.

[Radiologic diagnosis of diseases of the salivary glands (author's transl)]

Sialography of the major salivary glands is simple and without risk. Radiologic changes in their ducts permit certain differentiation between infective and malignant processes. Sialography determines further diagnostic and therapeutic action.

Diagnosis of experimentally induced bronchogenic tumours in the european hamster with bronchographs

Four groups of European hamsters were treated subcutaneously once weekly for life with 1/20 or 1/40 the diethylnitrosamine LD 50. Three animals from each treatment group and the two control groups were examined every three weeks by means of bronchographic technique. In four of the animals the bronchograms showed early neoplastic alterations of the bronchial system. The results demonstrate that bronchography is a suitable method for the diagnosis of bronchogenic tumours in the European hamster and that it also allows for the detection of displacing neoplasms of non-bronchogenic origin in the region of the tracheal bifurcation.

Radiological detection and sequential observation of experimentally induced bladder tumours in the European hamster

FOUR GROUPS OF EUROPEAN HAMSTERS (STRAIN MHH: EPH) were treated subcutaneously once weekly for life with 1/20 or 1/40 the LD(50) of DBN while another 2 groups served as controls. Three animals of each group were x-rayed every 2 weeks after i.v. injection of the contrast agent Urographin. By means of cystograms tumours of the urinary bladder were detected between the 20th and 26th weeks after beginning treatment when they had reached a diameter of 1-2 mm; their development was subsequently observed by periodical x-ray examinations. The technique described is simple and provides a valuable means for obtaining additional in vivo information concerning latency period, growth rate and identity of experimentally induced primary urinary bladder tumours in the European hamster.