[Endocavitary radiotherapy in an after-loading technic in malignant stenoses of the upper gastrointestinal tract and bile ducts]

Palliative brachytherapy with 192iridium in high dose rate technique was applied until August 1985 in 44 patients: 40 suffering from an inoperable malignant stenoses of the esophagus or cardia, and 4 from bile duct carcinomas located in the upper part of the duct. The patients with malignant stenoses of the upper gastrointestinal tract underwent laser therapy until an endoscope could be passed beyond this stenoses. Then an after-loading tube was placed endoscopically and the stenoses irradiated endocavitarily (7/Gray/session in 1 cm distance). In the patients with malignant bile duct obstruction a PTCD-catheter served to guide the iridium wire up to the stenotic region.

[Peripheral soft tissue sarcomas. A retrospective study on 90 primary treatment patients]

Between 1960 and 1982, 90 patients treated primarily for peripheral soft tissue sarcomas received a postoperative irradiation at the Irradiation Department of the Städtische Krankenhaus Passau. Five patients (6%) were inoperable for internistic reasons and were treated only by radiotherapy. The local recurrence rate after combined therapy was 26%. 44% of the patients (40/90) developed metastases, preponderantly in the lung and within the first year (70% each). The age-corrected survival rate was 63% after five years and 43% after ten years in 79 patients with complete postoperative irradiation. Important prognostic factors are the degree of malignancy (five-year survival times of 57 patients: almost 90% for G1 tumors, 50% for G2 tumors, and 17% for G3 tumors, statistically significant) as well as the completeness of surgery. It is shown by the available results that conservative surgical interventions combined with radiotherapy are not less effective than more radical operations.

[Nuclear magnetic resonance tomography in gynecologic tumors]

The article discusses initial experiences of NMR examinations of carcinoma of the uterus and cervix uteri (resistive magnet, NMR prototype of Siemens). All examined carcinomas show prolonged relaxation times. Variation of measurement parameters results in good optical presentation of carcinoma tissue in the resonance scans. The results are compared with those of CT-scans and in one case with the site of the operation.

[Recurrent ameloblastoma of the upper jaw--diagnosis]

Ameloblastomas of the jaw are rare epithelial tumors. They have to be differentiated from simple cysts and malignant tumors. If incompletely excised they have a high recurrence rate so that radical surgery from the beginning must be the therapy of choice. Exact preoperative diagnosis of the tumor and its possible spread into the infratemporal fossa or the pterygopalatine fossa, into the parapharyngeal space, the orbit or into the intracranial space is mandatory. In this paper we present a case with recurring ameloblastoma. The value of the different diagnostic procedures is discussed.

[Value and possibilities for the improvement of hysterosalpingography]

The diagnostic results of hysterosalpingography and laparoscopy were compared (30 patients). Agreement between the methods was found in 73%. In 17% of the women, findings seen on hysterosalpingography, could not be confirmed at laparoscopy. Conversely, in 10% of negative hysterosalpingograms, adhesions were found at laparoscopy. Possible causes for these differences are discussed. At present three different methods are used for hysterosalpingography. Compared with a metal cannula or a Foley catheter, the use of a baby's feeding tube resulted in a reduction of tubal spasm. A reduction in screening time and consequent decrease in gonadal radiation is possible without loss of diagnostic information.

[New aspects of radiotherapy planning with respect to the afterloading method in case of carcinomas of the cervix]

The authors examine the combination of percutaneous and intracavitary irradiation using the afterloading system. The isodoses are directly superposed on the CT zone. Two examples of different positions are given in order to discuss possible overdoses or underdoses, the radiation exposure of bladder and rectum as well as the necessary shielding.

[Diagnosis of renal involvement in malignant lymphomas (author's transl)]

The article describes involvement of the kidneys in 2 patients suffering from malignant lymphoma. In the first patient, small nodular infiltrates are seen in the symmetrically enlarged kidneys. In the second patient, a large, intrarenally growing tumour can be observed on the right, whereas on the left side an abdominal lymphatic node can be seen growing into the kidney. At the same time, there are lymphatic infiltrates of different size in both kidneys. The diagnosis is basically established by computerised tomography combined with visualisation of enlarged abdominal lymphatic nodes, both kidneys being involved; at the same time, the intrarenal infiltrates are found to possess a density which largely corresponds to that of the surrounding lymph nodes.

Computed tomographic demonstration of venous thrombosis of different etiologies

Typical computed tomographic signs of venous thrombosis include the demonstration of the hypodense center (20 to 45 HU) in the involved blood vessel with a hyperdense margin surrounding it. CT represents a reliable method of diagnosis complimentary to that achieved by venography. CT examination allows the visualisation of the proximal end of the thrombus and gives the etiology of the thrombus. Venous thromboses occurring for the first time demonstrate a well defined borderline around the vein with a lack of reaction in the surrounding tissue. On the other hand, recurrent venous thrombosis is characterized by an inhomogenous zone of higher density in the perivascular region. A similar image can be obtained in secondary thrombosis due to inflammatory changes from adjacent tumours. In cases of thrombosis with tumour involvement, the tumour can be demonstrated.

Immunoprecipitation of a cytoplasmic precursor of rat-liver cytochrome oxidase

A simple method for the isolation of rat liver cells is described. The cells are shown, by an isotope dilution method, to maintain a constant rate of protein synthesis for 8 h of incubation. Antibodies to purified rat liver cytochrome oxidase were raised in rabbits and used to investigate the labeling of cytochrome oxidase in isolated rat liver cells and in vivo. The data demonstrate the occurrence of a precursor of the subunits of cytochrome oxidase that are synthesized in the cytoplasm. 1. Dodecylsulfate gel electrophoresis of the immunoprecipitates from isolated rat liver cells that had been labeled with [35S]methionine for 1 h showed a single radioactive peak with a molecular weight of 50000. 2. Judged by the effects of cycloheximide and chloramphenicol the labeled protein is synthesized on cytoplasmic ribosomes. 3. After labeling for 1 h in vivo with [3H]leucine the labeled protein appears to be exclusively associated with the hepatic microsomal fraction. 4. Ouchterlony double-diffusion analysis demonstrated immunological relationship between the precipitates from microsomes and cytochrome oxidase. In addition to the precipitates derived from mitochondria and microsomes immunoprecipitates were also obtained from the cytosol in comparable amounts; these again were immunologically related. The occurrence of large amounts of precursor(s) (or degradation products) of cytochrome oxidase in rat liver fractions is interpreted in terms of a regulatory pool for amino acid homeostasis in the organism.

Restoration of pharyngoesophageal continuity with a replaceable prosthetic conduit: a new method

Treatment of carcinomas of the upper aerodigestive tract by high dose radiation and wide surgical resection result in large tissue defects. When the inferior pharyngeal constrictor and the cricopharyngeus muscles are removed, a replaceable prosthetic conduit can be used effectively to reestablish pharyngoesophageal continuity. This prosthesis can be readily fabricated and obviates the need for extensive reconstructive operations in suitable candidates.