Methodik und Ergebnisse von Stoffwechseluntersuchungen beim Krebs

Ohne ZusammenfassungMit 13 Textabbildungen     

Zur Frage der Durchlässigkeit der Blut-Liquorschranke für organische Arsenverbindungen

Zusammenfassung Abweichend von unseren früheren Untersuchungen wurde mit einer von Hawking angegebenen biologischen Nachweismethode die Durchlässigkeit der Blut-Liquorschranke für organische Arsenverbindungen geprüft.Es zeigte sich, daß dreiwertige Arsenverbindungen, wie Neosalvarsan und Spirotrypan, einem von den Höchster Farbwerken uns zur Prüfung übergebenen Präparat, in die Nervenflüssigkeit eintreten. Die trypanocide Wirkung der Nervenflüssigkeit nach Zufuhr von Neosalvarsan war geringer als nach Zufuhr von Spirotrypan. Unterschiede in der trypanociden Wirksamkeit der Nervenflüssigkeit bei verschiedenen Luesformen konnten nicht nachgewiesen werden. Die Entnahme und anschließende Untersuchung der Nervenflüssigkeit zu verschiedenen Zeiten nach Zufuhr der betreffenden Präparate ließen hinsichtlich der trypanociden Wirkung keine eindeutigen Unterschiede erkennen.Es wird vermutet, daß es sich bei dem trypanocid wirksamen Agens in der Nervenflüssigkeit um Abbauprodukte des Arsens im Sinne von Arsenoxyd handelt.     

Transthoracic esophagectomy and lobectomy performed in a patient with synchronous lung cancer and combined esophageal cancer and esophageal leiomyosarcoma.

We report a pitfall deriving from the assumption of metastatic disease based upon seemingly identical histology in a pulmonary lesion and in the esophagus. In a 60-year-old patient, cT1 esophageal squamous cell carcinoma was found. One of the two pulmonary nodules was histologically diagnosed as metastasis. When esophageal perforation occurred during palliative therapy, esophagectomy became necessary together with the right lower lobectomy for the removal of the remaining pulmonary lesion. Definitive histology showed pT1N0 cancer of the esophagus, primary esophageal sarcoma and pT4N0 bronchogenic carcinoma. The other pulmonary lesion was re-evaluated and defined as intralobar M1 of bronchogenic carcinoma.     

A CT-free, intra-operative planning and navigation system for minimally invasive anterior spinal surgery - an accuracy study.

OBJECTIVE: A comprehensive study was performed to evaluate the accuracy of a newly developed CT-free, intra-operative planning and navigation system for anterior spine surgery. MATERIALS AND METHODS: Instruments and an image intensifier were tracked using the SurgiGATE navigation system. A laboratory study was performed on 27 plastic vertebrae. Fiducial markers were implanted in the vertebrae for accuracy evaluation purposes, and a dynamic reference base was placed on the vertebrae to establish a patient coordinate system (P-COS). Two fluoroscopic images were used for intra-operative planning. The graft bed plan was recorded in P-COS, followed by surgical formation of the graft bed, which was visualized. To evaluate the accuracy, the vertebrae were scanned with CT, and the markers were used to calculate an accurate paired-point registered transformation between the CT coordinate system and P-COS. RESULTS: Using the new SPO module, accurate planning and navigation of a resection of the vertebral body is possible using two fluoroscopic images. The overall mean error between the planned resection volume and the actual resection was 0.98 mm. In addition, the module can serve as an educational tool for training spine surgeons. CONCLUSIONS: The new fluoroscopy-based system can be used safely for accurate performance of anterior resection during spondylodesis. New methods for safe and accurate registration during anterior spine surgery need to be developed.