Renal Artery Stenosis: Anatomic Classification for Percutaneous Transluminal Angioplasty

f(A.DIOLOGY) l'iTJCLEit~. lvIEDICil'cT:E

to the O'c,,-,w,-,,-,m,,on, and D~,ff,'hD~Q'"' successfcd with VVihr1s tumor, dependent mainly on removal. The authors stress radical resection with a retroperitoneal node dissection. Chemotherapy with actinomycin D, vincristine, cyclophosphamide and doxorubicin, a regimen directed more at an undifferentiated sarcoma than an embryonic tumor, is recommended. H.llf.S. 4 figures, 10 references

Editorial comment. Chemotherapy generally has been disappointing in children with clear cell sarcoma of the kidney. This tumor certainly has a poorer prognosis than Wilms but the outlook in a child is probably somewhat better than with the same tumor in an adult. L.R.K.

403

nTncrc,..,,s:i·,;;; and irreversible deterioration of renal function and was put on chronic ,,·-"'"'~·=, In 2 ether patients the renal function did not return to values before injection but remained stable. C.E.M. 3 tables, 21 references

Renal Artery Stenosis: Anatomic Classification for Percutaneous Transluminal Angioplasty K P. CxcuTo, G. K McLEAN, J. A OLEAGA, D. B. FREIMAN, RA. GROSSMAN AND E. J. RING, Departments of Radiology and Medicine, Hospital of University of Pennsylvania, Philadelphia, Pennsylvania Amer. J. Roentgen., 137: 599-601 (Sept.) 1981

Malignant Thymoma in an Eight-Month-Old Boy G. N.

E. FISHER, T. C. JEWETT, JR. AND A. L Division of Hematology-Oncology, Departments of Pediatrics, Pathology and Pediatric Surgery, State University of New York at Buffalo and The Children's Hospital of Buffalo and Department of Pediatrics, Roswell Park Memorial Institute, Buffalo, New York DESHPANDE, J.

FREEMAN,

J. Surg. OncoL, HI: 61-66, 1981 The authors report on an 8-rnonth-old boy who was found to have an anterior mediastinal mass on a routine chest x-ray. The child presented with mild respiratory distress, bilateral wheezing, and swelling over the neck and face suggestive of superior vena caval obstruction. The mass was removed and revealed malignant lymphocytic thymoma infiltrating the pericardium, great vessels and regional lymph nodes. Postoperatively, the patient received radiotherapy and chemotherapy. Thirty months after the diagnosis he apparently was free of any detectable tumor. Thymoma in children <15 years old is unusual. Of mediastinal tumors <5 per cent are true thymomas. Malignant thymomas in children always have poor prognosis. This child may be l of the very few patients who have survived >3 years and is believed to be the youngest patient with malignant thymoma. F. TA. 3 figures, 10 references

Based on their experience with 45 percutaneous transluminal angioplasties for atherosclerotic and fibromuscular disease the authors have classified retrospectively the renal artery lesions as renal, aortic or mixed. In renal lesions the luminal narrowing is completely within the confines of the renal artery proper. The aortic category of stenosis encompasses all lesions in which the renal artery itself is not narrowed but the segment of the renal artery lumen immediately contiguous with the aorta is compromised. In the mixed lesions the renal blood flow is decreased by a combination of renal artery and aortic disease. Grading the blood pressure response to therapy as excellent, good, poor or no response, the authors found that 83 per cent of those patients with renal artery lesions had an excellent or good result. Conversely, 76 per cent of the patients with aortic or mixed lesions responded poorly or not at all to the transluminal angioplasty. The authors believe that this classification is a useful predictor of response to therapy. However, they would not recommend withholding therapy on the basis of this system, since some patients with aortic and mixed lesions did get good results. G.F.S. 5 figures, l table, 4 references

Radiological Anatomy of the Internal Spermatic Vein(s) in 200 Retrograde V enograms F.

RADIOLOGY, NUCLEAR MEDICINE AND SONOGRAPHY Renal Function Impairment Caused UrogTaphy: A Prospective Study J. L.

R MARCEN, J.M. ONAINDIA, A. J. ORTUNO, Servicio de Ramon y Cajal, Madrid, Espana TERUEL,

QUEREDA AND

Intravenous C. Centro

SERRANO,

Arch. Intern. Med., 141: 1271-1274 (Sept.) 1981 Renal function was studied in 124 randomly selected patients in whom excretory urography (IVP) with Urografin- 76 per cent was performed as part of the diagnostic study. Urea (in serum and urine), creatinine, electrolytes and urinalysis were done before and 48 hours after injection of contrast material. A substantial deterioration of renal function was observed in 27 cases (21.8 per cent). In patients with a history of renal insufficiency the deterioration was more marked (55 per cent). The renal function returned to values before injection in 19 patients in a mean period of 12 days. One patient suffered

CoMHAIRE, M. KuNNEN AND C. NAHOUM, Department of Internal iVledicine, Section Endocrinology, Department Radiology State University Hospital, Ghent, Belgium and GEFERJ, Icarai-Rio de Janeiro, Brasil

Int. J. AndroL, 4: 379-387 (June) 1981

There were 200 male partners of barren marriages with palpable or suspected varicoceles studied retrog-rnde venography to establish the vascular patterns present in such patients. Reflux into the left internal spermatic vein was seen in 132 patients, into the right spermatic vein in 7 and into both in 33, No reflux was identified in 28 patients, although clinically evident varicoceles were present in 3 of them. In two-thirds of the cases a single venous outlet was present, while in the remainder collaterals were seen that often lacked effective valves. In 16 per cent of the patients with reflux venous filling contralateral communications to the opposite scrotum were identified but these occurred either at the pubic or scrotal level and always caudal to the level of the internal inguinal ring. In all, the study confirmed the diagnosis in 91 per cent of the cases, rejected it in 7.5 per cent and was false negative in L5 per cent. 5 tables, 12 references