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Purpose: To inform about the experiences by introducing this method, concerning feasibility, indication, procedure, histologic analysis, changes in admission of patients, consequences for the diagnostic work-up of breast lesions., Material and Methods: In 80 patients, 84 lesions were biopsied. The patients were chosen according to the "Breast Imaging Reporting A Data System", recommended by the American College of Radiology, with slight modifications. The examinations were performed on a mammographic unit with a special equipment for stereotactic biopsy, using a biopsy gun., Results: Histologic assessment was possible for all the cores provided. 12 of 84 lesions (14.3%) contained carcinoma, 53/84 (63.1%) mastopathic changes, 19/84 (22.6%) other benign findings. The percentage of out-patients was constantly high with 55%, the number of gynecologic in-patients increased slightly from 24 to 27%. The number of open biopsies decreased from 9 to 6 per month with a considerable decrease (30%) of negative biopsies., Conclusions: Co-operation with the admitting physicians, who are also doing mammography, should set a new course towards stereotactic core breast biopsy already before the patients are admitted to the hospital. An increasing acceptance by the gynecologists doing open biopsies could lead to a further decrease of unnecessary operations. The effect by direct histologic feedback improves the quality of mammographic diagnostic.

Arteriograms were carried out on 176 patients using 4-F catheters through a transbrachial approach. Criteria for exclusion from the series were injuries to the upper limb, hemiparesis or poor pulses in the presence of a normal femoral pulse. There were no local vascular complications requiring treatment. On two occasions the brachial artery could not be punctured. Acute posterior cerebral infarction was the only serious complication (0.5%). 67% of the patients were examined on an outpatient basis and this did not appear to increase the risk of complication. We regard this as a suitable method for demonstrating the pelvic and lower limb arteries on ambulant patients.

189 non-palpable breast lesions in 182 patients were localized using conventional mammographic apparatus, a wire grid compression plate and a cannula with a hooked mandrin. The technique of the examination for defining the lesion in three planes and fixation of the lesion with the wire is described. In 173 instances (91.5%), the lesion was found at the first biopsy and subsequent biopsies were necessary on only 24 occasions. One lesion (0.5%) was missed completely. 47 carcinomas were found (24.9%) and the incidence of malignancy increased from 14.3% to 33.3% during the series. The mean ratio defining the size of the biopsy and the size of the lesion was 3.3 and indicates good preservation of breast tissue. Radiographs of the specimen taken with compression showed 186 lesions (98.4%). The method, which is comfortable for the patient, provides satisfactory detection and localization of the lesions; results are similar to those of stereotactic methods but this method is quicker and much less expensive.

In 75 patients with lymphoma (46 Hodgkin's disease, 29 non-Hodgkin lymphomas) computed tomography was performed in order to detect neoplastic invasion of the abdominal organs (55 new cases) or to control the results of treatment (20 cases). In 30 cases enlarged retroperitoneal or mesenteric lymphnodes and/or liver or spleen enlargement were found. Neoplastic involvement of lymphnodes without enlargement was missed in two cases. CT failed also to demonstrate microscopic malignant invasion of liver and spleen. The false-negative rate in our series was 10.9%. Computed tomography is a non-invasive method which is very well suited for staging malignant lymphoma.

In three patients on cytostatic drugs acute bilaterally symmetrical pulmonary infiltrates developed. Bacterial, viral or mycotic infections were excluded. The histological findings in the lungs of two had died were those of nonspecific alveolitis. Clinical and radiological findings, as well as the rapid regression of the infiltrates after stopping the cytostatic drugs in the third patient and the marked similarity of the X-ray picture to some similar cases reported in the literature, suggest that these infiltrates resulted from an acute allergic reaction to the cytostatic drugs.

By using a PE-catheter for catheterising the tear ducts, dacrocystography becomes a simple and rapid investigation. It permits excellent morphological demonstration of pathological changes, since films can be obtained under screening control. A water-soluble, low viscosity contrast medium is recommended. Amongst more than 100 dacrocystograms, there were no serious complications.

Bronchial brushing under fluoroscopy control is used in the diagnosis of pulmonary lesions which are beyond reach of the bronchoscope. A small nylon or steel brush is passed through a bronchial catheter and tissue material from the lesion is taken for cytologic and bacteriologic studies. The technique described is easy to learn, relatively safe, is well tolerated by patients and gives good diagnostic results.

Intrabronchial retention of large plugs of inspissated mucous in cases of disturbed bronchial secretion and impaired clearing mechanism leads often to chronic inflammation and to formation of "proximal" bronchiectasis. Mucoid impaction may occur in many bronchial diseases and is radiologically characterized by the so-called "mucous bronchogram".

27 patients with testicular tumours were examined by lymphography and computerized tomography for evaluation of metastatic spread in the retroperitoneal lymphnodes. A good correlation of results was found in 23 patients. In 4 cases lymphography failed to show metastatic disease, which was easily recognized by CT. In account of the lymphatic spread pathways of testicular tumours leading mainly to the lymphnodes close to the kidney pedicle CT appears to be method of choice in the staging of these patients, as the lymphnodes in this area are often not demonstrated by lymphography. Computerized tomography allows the exact localisation and extension of neoplastic lymphnodes and at the same time a good evaluation of the surrounding organs.

Prompt surgical treatment of the solitary form of bronchiolo-alveolar-cell carcinoma offers a good survival rate in comparison with bronchogenic carcinoma; the prognosis of the diffuse form is poor. Review of 28 cases of solitary BAC showed an airbronchogram in 36% and a tail sign in 85% of cases; both features were found in 32% of tumors. The air bronchogram seems to be specific for this type of tumours, the tail sign is found with granulomatous or inflammatory diseases as well. In the differential diagnosis of a peripheral coin lesion with air bronchogramm and tail sign, without calcifications and atelectasis, a BAC should be taken into serious consideration.

Plasma cell granuloma of the lung is a rare, benign focal lesion of nonspecific inflammatory genesis with few symptoms and often discovered by chance during mass-radiography. Radiologically it is characterized by a usually well-circumscribed solitary round focus (70% of cases), as an infiltrate or as atelectasis if it grows endobronchially. The histological picture is polymorph with mature plasma cells, lymphocytes, vacuolized histiocytes, fibroblasts and other elements of the reticulo-endothelial system. It has been given many names, pseudotumour appearing in the older literature. In the differential diagnosis a peripheral lesion can be mistaken for benign tumour, specific granuloma or metastasis, the more central form for bronchial carcinoma. The condition was observed in six personal cases, operated on between 1967 and 1982.

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.

Algorithms in the diagnosis of malignant disease have the aim to produce a diagnosis as quickly, as certainly and as simply as possible. The first phase consists of general non-invasive methods which should be as simple as possible. If the results are positive this should be followed immediately by percutaneous biopsy in order to produce cytological confirmation of the diagnosis as quickly as possible. If the original investigations were negative, those special methods of investigation should be used which are most likely to make a diagnosis. This is followed by investigations which throw light on the most appropriate form of treatment. This scheme has been illustrated by special algorithms for carcinoma of the bronchus, the pancreas and the breast.

X-ray permeability is one of the important criterions which qualify a material as orthopedic cast. By using a phantom (amputated human lower leg) standardized conditions were created to compare the five customary casts: Cellamin, Lightcase II, Hexcelite, Neofrakt and Baycast. For judging the perceptibility of osseous structures, especially the details of the fracture, the lower and the upper number of clinically used layers were considered. The blank tested valuation showed the well-known advantages of the plastic materials in comparison with plaster of Paris. Within the group of the plastic materials distinct differences were also found.

The radiological due to extensive extramedullary haematopoiesis taking place in the posterior mediastinum in two patients are described, and the literature is reviewed. Characteristic features are a polycyclic or spindle-shaped configuration of the mass, with bilateral paravertebral localisation in the caudal and middle third of the thorax. There is absence of inflammatory or neoplastic changes in the neighbouring skeleton, but in thalassaemia there may be changes in the paravertebral portion of the ribs. Computer tomographically, the combination of a solid paravertebral tumour, with adjacent rib changes, is characteristic of thalassaemia with extramedullary haematopoiesis. In the absence of other skeletal changes, computed tomography is valuable for differential diagnosis. Lymphomas occur considerably more often and may appear identical but, because of the well know fat content of myolipoma, the scan shows contrast values between -15 and + 40 HU. Because of their high vascularity, there is a marked increase in density following intravenous contrast medium.

Transbronchial brush biopsy is indicated when routine methods fail to establish the diagnosis of a pulmonary lesion. More than 50 biopsies have been performed without complications. The diagnostic accuracy of about 50% positive reports will definitively improve with the better selection of cases and with greater experience with this technique.

Report is given on three cases of dacryolithiasis. All cases were demonstrated by dacryocystography. Two dacryoliths were obtained at operation, another one by spontaneous passage through the nose. Histopathological examination of the dacryoliths in two cases revealed the presence of a mycotic infection, most likely with Candida albicans. The casts were found to be composed of layers of neutral and acid mucoproteids and lipids, accompanied by an infiltration with leucocytes.

Bone tumors of the extremities are usually diagnosed by conventional radiography. A good angiogram may render information not only about intra- and extraosseous extension of the tumor, but often also about the biological dignity. CT is usually not necessary, especially since it is sometimes difficult to define the extraosseous borders of these extremity tumors with this method. In bone tumors of the pelvis, however, neither conventional radiography nor angiography render reliable information about the extent of the tumor, which CT is very well able to do. Therefore CT is primarily indicated for evaluation of bone tumors in this region. Angiography is done only for preoperative evaluation of the vascular architecture or for potential therapeutic embolisation.

Twenty-two patients with trauma to the pelvis and abdomen were examined by computer tomography. Subcapsular haematomas, haematomas and rupture of organs, intra- and retroperitoneal haematomas and pelvic fractures could be reliably diagnosed in this way. Serial observations on the tissue density of an haematoma allows one to judge its age. Lack of contrast enhancement of an haematoma makes the injection of contrast a useful test. Computer tomography has reduced the indications for angiography in blunt abdominal trauma.

After successful rescue from drowning there may develop a situation which is called secondary drowning, resulting in acute respiratory distress characterized by interstitial pulmonary oedema, hypoxaemia, hypercapnia and acidosis during drowning, direct alteration of the alveolar membrane by aspirated water and particulate matters and a volume overloading by adsorption and--not seldom--inept therapy. This situation requires mechanical ventilation and forced diuresis, combined with high doses of steroids, antibiotics and digitalis. We present the case of an eleven year old patient whose clinical course demonstrate the necessity of exact clinical observation after rescue from drowning. After development of acute respiratory distress only the immediate utilization of the therapeutic modalities of an intensive care may result in a satisfactory outcome. Four months later our patient had normal pulmonary function except for a moderate reduction of compliance.

Results and X-ray findings of 125 dacryocystographies are discussed. Type II obstruction is the commonest pathological finding, Type I is caused often by a trauma. DCG gives a good morphological picture of tear drainage system and represents a very important method for planning surgical therapy.

CT diagnosis of intraabdominal abscess was confirmed in 18 patients by laparatomy and in two by autopsy. In CT abscess is characterized by an expansive soft-tissue lesion with different density values, mostly with a central fluid collection and a thickened wall. The peripheral inflammatory reaction leads to obliteration of fat planes surrounding the adjacent organs. Further symptoms are contrast enhancement of the wall and extraluminal gas collection. The combination of all these signs together with a suitable history and clinical findings allow a reliable diagnosis of abscess formation. When only isolated signs are found, differentiation from tumor, pseudocyst or hematoma may be difficult.