Percutaneous extraction of centrally embolized foreign bodies: a report of 16 cases.

Sixteen cases of centrally embolized foreign bodies are reported (eight catheter fragments, two guide wires, four pacemaker electrodes, one ventriculo-atrial shunt, one Port-A-Cath catheter). In all patients only the Dormia basket was used. Foreign body extraction was successful in all patients except one, in which removal of a pacemaker electrode from the myocardium failed.

[The thoracic picture in acute traumatic aortic rupture].

We tried to find out the validity of 16 wellknown signs indicating an acute traumatic aortic rupture on plain chest radiographs of 22 patients. Angiographically 11 of all patients had a tear at the aortic isthmus. It turned out that 7 of the 16 signs (widened mediastinum, loss of the aortic knob contour, opacification in the aortopulmonary window, bulging of the vascular pedicle predominantly to the left, left apical cap, depression of the left main stem bronchus and displacement of the right paraspinous interface) are of great diagnostic value.

[Bronchioalveolar carcinoma].

A study of 21 patients suffering from bronchioalveolar carcinoma and 1028 comparable cases of the literature is presented. By this we gained statistical data concerning radiological and clinical manifestations of this rare tumour. However, radiological signs estimated to be typical of this carcinoma, like "rabbit ear sign" and positive "air bronchogram" are too rare to be really helpful for putting up the diagnosis.

[Primary malignant tumors of the pleura].

This study represents the examination of 14 primary, malignant pleural tumours--10 mesotheliomas and 4 sarcomas--in respect of the radiological appearance and clinical signs and symptoms. The presentation was widely different in the mesothelioma patients: 3 presented the radiological image of a mantle-like apicocaudal callosity. In 3 patients and extrapulmonary space-occupying growth was seen; one case presented with an interlobar effusion.

[Roentgen morphology and clinical picture of pulmonary hamartochondroma].

Based on a series of 44 surgical patients with hamartochondromas proven by histology the x-ray appearance and clinical aspects are shown. The percentage of calcified hamartochondromas is slightly higher than in the literature. Only one hamartochondroma was situated endobronchially.

[X-ray morphology and clinical signs of angiofollicular lymph node hyperplasia].

Five patients with benign angiofollicular lymphoma are reported - four with involvement of the mediastinum and one with abdominal disease. Chest X-rays and an intravenous pyelogram show the characteristic features of the disease. There are two histologic variants of this rare disease--one with and one without clinical symptoms.

[Gas- and fluid-containing cavities in the small pelvis and their differential diagnosis].

Since untreated intra-abdominal abscesses are associated with a high mortality rate, early diagnosis is important. In abscesses involving gas formation, plain radiographs of the abdomen in various projections are sufficient for diagnosis. In this article, differential diagnosis of cavities containing gas and fluids is discussed.

[The importance of angiography in primary retroperitoneal tumors (author's transl)].

During the past ten years, 18 patients with primary retroperitoneal tumours were operated on in the Second Surgical Department of Vienna University. Angiography was performed preoperatively in seven patients. In five out of seven patients, the origin of the tumour and its histological grade could be determined angiographically.

[Penicillamine-induced elastosis perforans serpiginosa and pulmonary cyst in Wilson's disease (author's transl)].

A large air cyst was removed from the right lung of a 29-year-old female patient with Wilson's disease and penicillamine-induced perforating elastosis, the cyst first appearing after 9 years of treatment with penicillamine. Since, on the one hand, the microscopic and ultrastructural changes in the elastic tissue of the lungs were identical to those observed in the skin, both in areas of clinically-demonstrable elastosis perforans serpiginosa and clinically unaffected skin and, on the other hand, no other pulmonary disease was demonstrable to account for the development of the cystic lesion, it is concluded that penicillamine is the causative factor by means of extensive alteration of the elastic tissue. The morphological changes in the elastic fibres are so characteristic that it is easy to distinguish penicillamine-induced elastosis perforans serpiginosa from the idiopathic variant.

[Extra-anatomical bypass grafting in high-risk patients (author's transl)].

Extra-anatomical grafting (axillo-femoral and femoro-femoral bypass) seems to present a possibility of saving the lower limbs from amputation in high-risk patients with severe decompensation from arterial occlusive diseases of the legs. A case description is given of 20 patients, in whom 21 bypass procedures were carried out. The results with axillo-femoral bypass proved satisfactory and this method of intervention can be recommended as an emergency operation in high-risk patients.

[Diagnosis of combined malformation of lung and pulmonary vessels (author's transl)].

Diagnosis of combined malformation of lung and pulmonary vessels are presented in a case of one lobe lung on the right (Agenesis of two lobes and hypoplasia of the presenting lobe). The importance of radioisotope methods in diagnosis of lung hypoplasia is stressed. Pathogenesis and period of teratogenic termination is discussed.

[Femoro-crural reconstruction in preference to amputation (author's transl)].

22 cases of arterial occlusion below the branching of the popliteal artery and 1 case of traumatic subtotal amputation of the calf were revascularized by autogenous femoro-crural vein bypasses. All patients had pain at rest and/or gangrene. So far, with an average bypass patency of 15 months in two of three equal parts of the operated legs, the decision to try reconstruction instead to amputate has met with successful results.

[Angiographic diagnosis of ovarian cancer (author's transl)].

The methods of examination which are usually used in cases of tumours of the lower abdomen are mostly not able to determine the site of origin of the lesion of its histology unequivocally. Angiographic examination techniques enable the definition of such tumours and very often allow the differentiation between benign and malignant lesions. Both hypogastric arteries are selectively or semiselectively catheterized using Seldinger's technique.

[Can pathological changes in the upper arm and axilla prevent a successful axillary plexus block? A case report].

Even if one can find in the literature many contra indications to nerve blocks, this case with a pseudarthrosis of the humerus and severe scars in the axilla shows that non-inflammatory pathologic-anatomical changes need not prevent a brachial plexus block. Prerequisites are the ability to palpate the axillary artery and a reliable technique.

[Clinical significance of arteriovenous shunt malformations in the uterine and adnexal region (author's transl)].

This case report describes and discusses the entity of arteriovenous shunt malformations in the uterine and adnexal region. The diagnostic measurements and clinical importance of this disease is also outlined. The condition is rare, but should be considered in cases of severe hemorrhage when routine investigations have been normal.

[A rare cumulation of vena cava catheter complications in the same patient (author's transl)].

Two complications that occurred in connection with the use of CVP catheters in the SVC and IVC in one patient are described: 1. Extravascular injection in the superior mediastinum and in the extrapleural space. 2.

[About the angiographic diagnosis of intestinal carcinoids (author's transl)].

Using two angiographically well documented cases the angiomorphological features of intestinal carcinoid tumors are described. One case is a carcinoid of the terminal ileum with hepatic metastases, the other case a cecal carcinoid without distant metastases. The primary tumor of the second case is strikingly hypervascular--most primary carcinoid tumors heretofore described in literature were hypovascular.

[A new method for direct measurement of the aortofemoral pressuregradient in connection with translumbar aortography (author's transl)].

A new method to measure simultaneously and directly the aorto-femoral pressure-gradient is described. The study can be performed in connection with translumbar aortography. In addition of being easy to perform the following advantages can be obtained by using this method: 1.

[Differential diagnosis of tumors in the pelvis of gynecologic patients by angiography (author's transl)].

The value of angiography in differential diagnosis of tumours of the pelvis is discussed based on 15 cases and the relevant literature. Inflammatory infiltrates and neoplasms arising from the sigmoid colon can be separated from gynaecologic tumours by angiography. In 4 cases with pelvic masses in which differentiation between a myomatous uterus and an ovarian tumour was not possible clinically, unequivocal evidence was cleaned from a selective injection into the internal iliac artery.

[Doppler ultrasound diagnosis of extracrânial carotid stenoses (author's transl)].

Percutaneous measurements by Doppler ultrasound techniques over the supratrochlear, supraorbital and common carotid arteries may detect the presence of a stenosis in the internal carotid artery between the bifurction and the branching of ophthalmic artery. Out of 200 patients examined by Doppler ultrasound 60 patients underwent carotid angiography and the angiographic data were compared with the noninvasive results. The diagnostic accuracy was 85% in cases with stenoses greater than 50% and occlusions; in cases with stenoses of greater than 50% it was 78%.