Chest Wound and Hematuria

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be attempted in all patients with renal artery stenosis. Only in patients with severe atheromatosis of the aorta should the risk associated with the catheterization be weighed against the 56 per cent or so chance of benefit from the procedure. Author's abstract 3 figure, 2 tables, 11 references

Abstracter's comment. The 2 complications mentioned by the authors were a death and a leg amputation resulting from embolization with atheromatous material. Sodium warfarin was used as an anticoagulant and continued for 6 months after treatment, and the authors cite this as a possible explanation for the absence of delayed failures as described by others. However, to a certain extent the results are a bit difficult to interpret, since the classification of cured, improved or no change was made while many of the patients were still taking medication. T. D. A.

TRANSPLANTATION Recovery of Renal Function After Prolonged Dialysis and Transplantation T. 0. NUNAN, E. A. STEVENS, D. N. CROFT, P. J. HILTON, N. F. JONES AND A. J. WING, Departments of Renal and Nuclear

Medicine, St. Thomas's Hospital, London, England Brit. Med. J., 287: 248-249 (July 23) 1983

It is estimated that among patients receiving dialysis for >6 weeks 0.6 per cent will exhibit recovery of renal function sufficient to discontinue dialysis for intervals of ~3 months. In this report 7 of 250 patients with renal failure (2.8 per cent) showed such a phenomenon. Of these patients 4 were on chronic dialysis and clinical improvement clearly heralded the recovery: 2 had mesangiocapillary glomerulonephritis, 1 had crescentic glomerulonephritis and 1 had Goodpasture's syndrome. Dialysis had been for 12 to 13 weeks in 3 patients and 41 weeks in 1. Two patients remained in remission for nearly 1 year and The Role of Fibrin Adhesive in Vascular Surgery 2 for 3.5 to 4 years. Three patients who had undergone cadaveric renal transM. G. IKoss1-0'CONNOR, J. L. AMBRUS AND U. RAO, Department of Experimental Surgery and Pathophysiology, plantation were discovered accidently to be subsisting on their own kidneys when a routine renal scan disclosed that the renal Roswell Park Memorial Institute, Buffalo, New York allograft had ceased to function. Two patients with accelerated J. Surg. Oneal., 23: 151-152 (July) 1983 hypertension remained in remission for 64 and 74 weeks, and 1 with crescentic· glomerulonephritis still was well 2.5 years Mongrel dogs underwent bilateral transection of the femoral later, with a creatinine of 0.9. The significance of these obserarteries. The right artery was reanastomosed with the smallest vations as they relate to the followup of renal transplant number of sutures possible and Fibrin Seal (fibrinogen, cold patients, need for continued immunosuppressive therapy and insoluble globulin, factor XIII, platelet growth factor, antiplaswisdom of bilateral nephrectomy is discussed. T. D. A. min thrombin and calcium chloride). The left artery was used 1 figure, 2 references as a control and reanastomosed in the classical fashion without Fibrin Seal. A significant decrease in the number of sutures necessary to achieve adequate hemostasis and postoperative bleeding was noted. No long-term increase in tissue reaction or decrease in arterial ·patency was noted. Fibrin Seal may be a ANDROLOGY useful tool for vascular hemostasis. However, more extensive studies attempting to define its role and drawbacks are recom- Prevalence of Cytomegalovirus and Herpes Simplex Virus in Human Semen mended. C. E. M. 1 table, 9 references M. P. McGOWAN, K. HAYES, G. T. KovAcs AND J. A. LEYDON, Medical Research Centre, Prince Henry's Hospital, Melbourne, Australia, Virology Department, Fairfield Hospital, Fairfield, Australia, and Department of Paediatrics, Monash University, Melbourne, Australia

TRAUMA Chest Wound and Hematuria

H. WOGALTER, Department of Urology, Nassau Hospital, Mineola, New York N. Y. State J. Med., 80: 1040 (July, Aug., Sept.) 1983 This letter to the editor describes a gunshot wound to the right side of the chest with the point of entry being in the fourth intercostal space near the nipple. No exit wound was seen. The patient experienced transient gross hematuria. The bullet subsequently was found to be lodged in the right kidney and was removed with preservation of the kidney. The author suggests that the urinary tract may be involved with trauma even if the area of trauma appears to be remote from the urinary tract. This is especially true if hematuria is present. D. K. M. 1 figure, 1 reference

Int. J. Androl., 6: 331-336 (Aug.) 1983 Cytomegalovirus was isolated from semen in 4 of 170 male patients and 1 of 40 healthy university students. All initial isolates were from specimens with abnormal semen analysis. Herpes simplex virus was not isolated from any sample. If cytomegalovirus or herpes simplex virus is transmitted sexually via semen there is the possibility that abnormalities owing to prenatal or perinatal infections may occur through artificial insemination procedures. Since the semen analysis is abnormal in patients with cytomegalovirus excretors (leukocytes >10 6 /ml., pH >8 and low seminal fructose) they automatically will be excluded from the donor program. Because of this finding it is not necessary to culture the semen for cytomegalovirus. Herpes simplex virus was not found in any of the semen samples. Therefore, the authors suggest that determination of this parameter is not necessary in artificial semen donors. P. R. R. 2 tables, 13 references