Ceskoslovenska radiologie最新文献

Twenty transabdominal unilateral lumbar sympathectomies were performed by the Chiba needle under the control of computer tomography. The intervention was made for advanced occlusive disease of lower extremities, where a reconstruction surgery was not possible. In nine patients under evaluation, excellent effect was seen in two, marked effect in two others, uncertain one in another patient while four patients were without any gain. An alcoholic solution containing a local long-term acting anaesthetic and a contrast medium was used as a blocking agent. The method may be useful even in an advanced disease and extends the series of diapeutic methods.

In 28 newly discovered diabetic patients of 2nd type (non-insulin-dependent diabetics), computer tomography was used to determine the density of pancreas and kidneys, densities of liver, spleen and blood in abdominal aorta and to follow the occurrence of further pathological changes in the above mentioned tissues. The results were correlated with laboratory findings. The following changers were found: decreased density of pancreas (29.4 H) and liver (49.1 H) and increased density of spleen (56.3 H) and blood in abdominal aorta (43.7 H). The decreased density of pancreas appears to be connected with disorder of lipoprotein metabolism. The decreased liver density was related to increased energy intake in the food and overweight, evaluated by the Broc's index. Other findings of computer tomography in the newly discovered diabetics of 2nd type (changes in the size of pancreas, kidney, kidney cyst, nephrolithiasis, sclerotic plaques on aorta) were not significant.

The author describes the results of therapy in three groups of patients (128 patients altogether) with the superior vena cava syndrome caused by a tumorous disease. All the patients were treated by radiotherapy as a main method of therapy. (200 kV, filtration 2 mm Cu) in a daily fractionation 300 r on the surface by one field, in the second period (1974-1978) 55 patients were irradiated by 60Co cobalt from two opposite fields by daily fractionation of 170-180 rad into the focus and in the third period (1984-1986) 25 patients were irradiated by 60Co cobalt from two opposite fields in 3-4 introductory daily fractions 3.0 Gy into the focus and then in normal fractionation up to the total dose planned. Immediate results of the treatment--complete disappearance of the syndrome symptoms--were the best in the 3rd group, where a complete disappearance of the symptoms was observed in 84% of patients and a partial relief in 8%. In the first period a complete disappearance of symptoms was in 54% and a partial relief in 10% of patients. The corresponding values in the second period were 74% and 11% respectively. In evaluating the survival of patients, no significant differences were found. In the first period, 50% of patients survived 12 weeks, in the second period 16 weeks and in the third one 20 weeks. One-year survival was reached by two per cent of patients in the first period, four per cent in the second period and eight per cent in the third period. The paper discusses other therapeutic possibilities and approaches in the treatment of the superior vena cava syndrome.

The case history of patient is presented who was diagnosed a tumor in abdominal cavity in an ultrasonographic examination. In the following surgery the tumour was extirpated and histology verified a liposarcoma. The control ultrasonographic examination revealed a growing solid formation in the region of resection. For presumed relapse of liposarcoma the patient underwent laparotomy again. In the region of the original tumour there was a conglomerate of adhesions in a size of tangerine. The histological examination revealed fibrous and fatty tissue without the sign of malignity.

The author investigated the effects of vibration, 125 Hz, on blood supply of hands in 43 healthy students. The temperature of fingers was followed by thermovision camera, the source of vibrations was a specially constructed vibration simulator which enabled to change vibration frequency. Thermographic recordings were made before the vibrations, immediately after the vibrations, 30 and 60 min. after the vibrations, respectively. Maximum temperature changes were always observed 60 min. after the vibrations. The temperature gradient 3-5 degrees C between the back of the palm and the fingers was demonstrated 60 min. after the vibrations in five healthy students (11%), although there was not any temperature gradient before the vibrations there. The negative finding lasted even in repeated examinations, the positive one was sometimes of different nature.

One hundred and sixty patients with the diagnosis of prostate cancer have been treated at the Research Institute of Clinical and Experimental Oncology in Brno over the last 10 years. The present paper has been devoted to the diagnostics of skeleton by scintigraphy as compared with X-ray examination of bones. Scintiscanning of skeleton was performed on a gamma-graph Picker 500 i, 99mTc pyrophosphate was used and scintiscanning was performed in the usual examination regimen. The highest importance of this examination resides in the fact that the demonstration of bone metastases results, in most cases, in changing therapeutic procedure and thus significantly influences the course of the disease and the patient's fate. In the group of patients the authors detected metastases in the skeleton in 40% during the first examination of skeleton, sometime even after introducing the therapy. The results confirm the necessity of a complex skeleton examination before the onset of therapy in each patient with this kind of diagnosis.

In the period of 10/1980-12/1985 the authors performed 102 percutaneous transluminal angioplasty operations on 95 patients in the area of pelvic vascular bed and arteries of lower extremities. The authors evaluated the values of systolic gradient before and after the intervention. Computer assisted statistical methods were used in the search of relationship between the value of systolic gradient and duration of clinical improvement after the surgery. There was not any statistically significant relation between the values of S-gradient before and after PTA and the long-term fate of the patients treated by this method. The authors are of the opinion, though, that measuring this value provides a useful information in the course of surgery.

On the case of 10 years old boy with chyluria the authors emphasize the importance of lymphographic examination for proving the pyelolymphatic connection. The lymphographic examination was applied after the complete examination including computer tomography and ultrasound, since these examinations did not prove changes of the urinary and lymphatic systems which could explain the milky clouding of the urine lasting for several months. Changes in the biochemical profile were significant as well as non-constant ejaculation of milky cloudy urine from the opening of the right ureter. The lymphographic examination proved the link between the lymphatic urinary systems with changes on the lymphatic vessels and nodes.

The authors describe their experience in two cases of mechanic desobliteration and subsequent percutaneous transluminal angioplasty in a chronically occluded renal artery. It has become obvious that although this surgery has been so far performed only rarely it is technically viable and may exert a favourable therapeutic effect on hypertension of renovascular etiology as well as angioplasty of stenosing lesion of kidney arteries. The paper also discusses a possibility of influencing renal function by this method. The authors arrive at the conclusion that recanalization of a chronic occlusion of renal artery extends the presently relatively stabilized indications for percutaneous transluminal angioplasty in this localization.