The discriminatory capacity of BMD measurements by DXA and dual X-ray and laser (DXL) at the calcaneus including clinical risk factors for detecting patients with vertebral fractures.

Unlabelled: Osteoporotic fracture risk depends on bone mineral density (BMD) and clinical risk factors (CRF). Five hundred and eighty-eight untreated female and male outpatient subjects were evaluated, 160 with vertebral fractures. BMD was measured both by using calcaneal dual X-ray and laser (DXL) and dual-energy X-ray absorptiometry (DXA), and CRF were evaluated.

Prevalence of vertebral fracture in elderly men and women with osteopenia.

The objective of our cross-sectional, not population-based, observational study was to determine the prevalence of patients with osteopenia in relation to bone mineral density (BMD) and vertebral fractures and to identify risk factors for vertebral fractures above the osteoporotic BMD T-score threshold of -2.5. A total of 698 consecutive hospitalized and ambulatory white patients with T-scores between -1.

Embolization of bone metastases.

Purpose: To assess the effectiveness and clinical usefulness of transcatheter embolization of bone metastases.

Patients And Methods: The procedures and outcome of 61 transcatheter embolization procedures performed in 51 patients with hypervascular skeletal metastases were retrospectively evaluated. Results from computed tomography, magnetic resonance imaging, and diagnostic angiography, performed before and after embolization, were reviewed.

[Sonographic findings following laparoscopic cholecystectomy].

In a prospective study 500 patients were examined sonographically following laparoscopic cholecystectomy, 183 on several occasions. In the majority of patients (79.4%) there were no remarkable findings, either clinically or sonographically.

[Drain fistulography. Radiological sphincter identification in high anal fistulae].

To warrant permanent surgical cure of high anal fistulae, while avoiding at the same time faecal incontinence due to inadvertent division of the puborectalis muscle, distinction between a trans- and suprasphincteric fistula track is essential. This differentiation is often crucial, since digital rectal palpation and conventional fistulography tend to be unreliable. Therefore we developed a radiological technique of imaging the anorectal fistulous track, "drain fistulography".

[X-ray measurement of the level of rectal carcinomas and its dependence on the functional status of the pelvic floor].

The influence of the various functional states of the pelvic floor on the radiological assessment of the tumour levels and the distant tumour-free distance in rectum neoplasms was investigated. The parameters "anal canal length", "anorectal angle" and "impression of the puborectalis muscle" were measured in lateral distant views of the rectum in a series of healthy controls (n = 160). In addition, these parameters and the "distant tumour-free distance" were measured in patients with rectal cancer (n = 40).

Sonographic demonstration of septicaemia with gas-forming organisms after liver transplantation.

Sepsis with gas-forming organisms, e.g. Clostridium perfringens and anaerobic streptococci occurred in three of 120 liver-transplant recipients (2.

Lymphoid follicular hyperplasia in excluded colonic segments: a radiologic sign of diversion colitis.

Double-contrast barium enema (DCBE) studies showed lymphoid follicular hyperplasia (LFH) in excluded colonic segments after colostomy in 12 of 40 patients. In most patients with LFH, more than 80% of the excluded colon was affected. In eight patients, regression of LFH was demonstrated with DCBE studies after reanastomosis.

The relationship between the common femoral artery, the inguinal crease, and the inguinal ligament: a guide to accurate angiographic puncture.

The variability of the extraperitoneal puncture space between the inguinal ligament and the inguinal crease was evaluated in 100 patients. The distance between the inguinal crease and the inguinal ligament varied from 0 to 11 cm (average 6.7 cm +/- 1.

[Sonography of acute cholecystitis. A report on 58 cases with a correlation of pathomorphological and histological findings].

Sonography has become the method of choice for evaluating acute diseases of the right upper quadrant. Prior to the ultrasound the diagnosis of acute cholecystitis was based on clinical and laboratory data. The pathohistomorphology of 58 opertively and histologically proven cases of acute cholecystitis has been correlated with preoperative sonography.

[Results of colo-anal anastomosis in deep-seated tumors of the rectum].

Colo-anal anastomosis as surgical procedure for low rectal tumors was analysed in regard of complication rate, functional and oncological results. The sensibility of the method particularly in tumors near the anal sphincters, was assessed by means of a new radiological procedure (lateral distant view). From 1982 to 1985 colo-anal anastomosis was performed in 30 patients with rectal carcinoma.

Irradiation-induced changes in the subclavian and axillary arteries after radiotherapy for carcinoma of the breast.

Three case reports are reviewed to illustrate the possibility of treating irradiation-induced lesions of the subclavian-brachial vascular segment (aneurysm and segmental occlusions) 14, 20, and 26 years after radical mastectomy and subsequent radiotherapy. All patients had an extraanatomic vein bypass graft from the carotid to the brachial artery crossing the shoulder near the acromioclavicular joint, with the advantage that the tissue changed by radiotherapy or infected by ulceration could be circumvented. There were no postoperative complications, with adequate function of the grafts (follow-up, 17, 24, and 20 months, respectively).

[Roentgen studies (lateral distance image) for precise determination of tumors of the rectum].

The lateral distant view (LDV) of the rectum is proposed for more precise identification of localization of rectal tumors for preoperative planning and to increase the number of sphincter saving operations. In a prospective study 129 patients with rectal tumors were compared with radiologic and rectoscopic measurements and with the intraoperative tumor site. Other factors which may influence the resectability of tumors have been examined in a part of this patients by measuring the width of the presacral space, the anorectal angle and the pelvic diameters by radiological pelvimetry.

[Sonographic studies of the aorta after prosthetic replacement (follow-up of 112 patients)].

Sonography should be routinely used for clinical follow up of patients with prosthetic grafts replacing the abdominal aorta and iliac vessels. 112 patients were investigated and the normal findings as well as pathological changes following aortic graft implantation are described and the difference between Dacron and PTFE-Y graft material discussed. Adequate visualization of anatomic detail of the graft was found in 82.

[Real-time sonography in breast diagnosis. Indication and value].

With improvement in ultrasound technique, sonography is gaining increasing importance in the evaluation of breast lesions. The following conclusions are drawn on the basis of experience in the use of real-time sonography in 200 patients. Palpable masses are most suitable for examination by sonography, whereas the diagnostic yield in diffuse breast disease is relatively low.

Postoperative assessment of below-knee bypass grafts.

Our results seem to demonstrate that, even when healthy or arteriosclerotic arteries tolerate knee flexion without any impairment of blood flow, all bypass materials, to a certain extent, have a tendency toward morphologic changes, such as kinking, looping, stenosis and decrease of peripheral blood flow. Reocclusion in below-knee reconstruction, which cannot be explained by poor outflow situation or technical faults, might be related to the graft material used as well as hemodynamic changes caused by flexion of the knee joint. With the use of ASV grafts, these changes are minimal and of little or no clinical importance; when HUV is used, these changes are more distinctive and might, in some instances, be the cause of reocclusion.

[The PTFE plastic prosthesis as an arterial replacement: experiences over a 5-year period].

Unilateral iliac femoral reconstructions with PTFE are yielding good results-similar to those with Dacron, with patency rates of 75, 67, and 65% at 1, 2 and 3 years, respectively (Kaplan-Meier). PTFE has additional advantages compared with other materials: a) no need of preclotting; b) smooth inner surface-easy thrombectomy in case of thrombosis and c) good handling characteristics. In view of the above-mentioned facts PTFE can be recommended without restriction for unilateral pelvic reconstructions.

Lateral distant view for improved accuracy in locating rectal tumors.

The lateral distant view of the rectum is proposed for more precise identification of sites of rectal tumors for preoperative planning and to increase the number of sphincter-saving operations. In a prospective study of 39 patients with rectal tumors, radiologic and rectoscopic measurements of tumor levels were compared with each other and with the actual tumor site. Radiologic measurement on the lateral distant view showed that tumors usually are located much higher (2-11 cm) than is suggested by rectoscopic evaluation.

[The PTFE-Y bifurcation prosthesis: early results].

During the past 2 years (April 1981-March 1983) 50 PTFE Y-grafts were implanted. The early results are good. Except one graft limb occlusion (8 months postoperatively), which was successfully managed by thrombectomy, all grafts are functioning well or did so until death.

False aneurysm treated by a combined approach of coil embolization and autologous vascular grafting.

A serious complication associated with vascular surgery is active or potential hemorrhage due to infected pseudoaneurysm. In two cases of false aneurysm, embolization with the Gianturco-Anderson-Wallace (GAW) coils was performed and blood supply was preserved by autologous vascular grafts, thereby emphasizing the feasibility of a combined approach in patient management.

[Roentgenologic findings following total transposition of the stomach as a replacement for long segments of the esophagus].

Thirty-seven patients, in whom the stomach had been transposed in order to replace a long segment of the oesophagus, were studied. Radiologically important early complications and the late results of this surgical technique were correlated. Twenty-five patients were observed radiologically and clinically for a period of three to 20 months.

[Ischemia syndrome of the upper extremities not due to cardiac causes. Proximal arterial stenosis with embolization into the periphery].

Five cases are reported with the pathological entity of proximal arterial stenosis and embolization into the peripheral vascular bed. Therapeutic management, e.g.

[Problems arising in connection with surgical management of renovascular hypertension (author's transl)].

65 consecutive renal artery stenosis reconstructions for the treatment of severe renovascular hypertension are reported. 63% of the cases were males, 37% females. The disease was caused by arteriosclerosis in 66% of cases and in 23% by fibromuscular dysplasia or other pathological changes of the renal artery; the mean age was 47 in the former.