Accuracy of two systems--conventional (DRF 400, Diasonics) and color-coded (Angiodynograph, Quantum/Phillips) image-directed Doppler ultrasonography--was investigated using an in vitro model that generated both monophasic and triphasic pulsatile flow patterns. Estimated and actual blood volume flow rates showed good correlations, but the sampling with a hand-held transducer led to wide variations in measurement error for the conventional (-69.2% to 50%) and the color-coded (-79.3% to 265.7%) systems. By performing multiple measurements, one could improve accuracy considering only the maximal values of a series instead of the mean values. Accuracy was impaired by interposed muscular or fatty tissue due to false low time-average velocity measurements caused by a loss of Doppler signal. Comparison of both systems revealed significant differences between pulsatility index values (p less than 0.001), blood flow velocities (p less than 0.001), and blood volume flow rates (p less than 0.05 for program flow, p less than 0.001 for manual and automatic flow program of the color-coded system).

Serial thoracic CT scans of 50 consecutive patients with testicular cancer were reviewed. In 30 of them with metastatic disease treated according to the Einhorn Scheme changes in thymic size caused by cytostatic agents were studied. During chemotherapy 78.6 per cent of all patients examined developed thymic atrophy, followed by rebound enlargement that reached its culminating point 13 months after initiation of treatment. After that a slow (approximately 2 years) involution process began, until the initial size or somewhat smaller size was re-achieved. The other 20 patients with no evidence of metastases, and therefore not treated with chemotherapy, showed no changes in thymic size. Rebound thymic enlargement following cytostatic therapy for metastatic testicular cancer should not be mistaken for lymphadenopathy.

No abstract

Transcatheter embolization was performed in 45 patients suffering from potentially lethal bleeding originating from malignant tumours in the pelvic region. In 21 cases, the basic disease was rectosigmoidal and in 20, gynaecological in origin. Uncommon bleeding sites were embolized in four other cases. The median survival time (Kaplan-Meier) was 6 months. Most patients died from tumour cachexia. In 10 cases (22%), recurrent bleeding occurred, in three of these with lethal consequences. Successful reembolization was performed on seven patients. The different embolization materials used showed a minor impact on the therapeutic result. Embolization therapy proved to be an effective measure in potentially lethal malignant pelvic bleeding. Gianturco, Anderson and Wallace (GAW) coils should be given preference where there is urgency, as they are accurate, easily and quickly insertable, and cause few complications.