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Ultrasonically guided renal cyst aspiration
gross hematuria,
recurrent urinary tract infections, and hydronephrosis are most often seen. Excessive excretion of oxalic, glycolic, and glyoxylic acid occur in this disease. The treatment of oxalosis has proved to be most unsatisfactory. High fluid intake, the administration of phosphate in large doses to inhibit crystal formation, and the use of pyridoxine in doses of 150 mg. per day have been recommended. Hemodialysis has been generally unsuccessful, although it temporarily reduces the concentration of oxalate. Homotransplantation has also proved unsuccessful; at autopsy, kidneys have shown oxalate deposition. The authors recommend high fluid intake, early diagnosis, and the determination of urinary oxalate excretion in patients with calcium oxalate stones. Studies on Renal Function After Relief of Complete Unilateral Ureteral Obstruction of Three Months’ Duration in Man, Ori S. Better, A. I. Arieff, S. G. Massry, C. R. Kleeman, and M. H. Maxwell (54: 234, 1973)-A case is presented in which a ureter was ligated inadvertently following pelvic surgery for massive uterine hemorrhage and was not detected for three months. A nephrostomy was performed, and a controlled study with the opposite kidney serving as the control was established to monitor the degree of return of function. At the time of the nephrostomy, the creatinine clearance was 2.7 ml. per minute. This rose to 10.2 ml. per minute within one week but remained unchanged thereafter. The filtration fraction (Cw : CPAH) was 0.22 in the normal kidney and 0.19 in the diseased kidney. The normal kidney concentrated three times better than the involved side. Phosphate excretion and the ability to acidify the urine were both diminished on the involved side. There was increased excretion of sodium chloride; however, the free water clearance was supernormal. Ureteral obstruction occurs in approximately 2 per cent of pelvic surgery. The authors have shown that even after complete obstruction for three months, a kidney able to support life can be salvaged with appropriate reconstructive surgery.
JOURNALOFUROLOGY by Daniel
Howard,
M.D.
Ultrasonically Guided Renal Cyst Aspiration, Barry B. Goldberg, and Howard M. Pollack (109: 5, 1973)In this report the authors describe their technique of utilizing ultrasound to differentiate cystic from solid mass found pyelographically and to aid in placing a needle within the cyst for aspiration. A specifically modified ultrasonic transducer containing a central lumen permitted ultrasound to be used as a guide in renal cyst aspiration. Sixteen patients with proved renal cysts underwent cyst aspiration with the use of this technique. The ultrasonic transducer was first used to localize the cyst and to provide information as to the exact size and depth of the mass. Utilizing this knowledge the proper length needle was selected, and a needle was passed through the lumen in the transducer into the tissues.
340
UROLOGY
/ SEPTEMBER
1973
Furada&@ Tablet.9 (nitrofurantoin) Furadantin Oral Suspension (nitrofurantoin). Furadantin Sodium Parenteral (nitrofurantoinsodium). Indications: Indicatedfor the treatment of pyelonephritis, pyelitis and cystitis due to E. coli, enterococci, Staph. aureus, some strains of Klebsiella-Aerobacter and Proteus, or a small percentage of strains of Pseudomonas, when demonstrated to be susceptible by in vitro susceptibility testing. Not indicated for the treatment of renal cortical or perinephric abscesses, systemic infections, prostatitis, or in any genitourinary tract infections other than pyelonephritis, pyelitis or cystitis. FURADANTIN Sodium should be used only in patients with clinically significant urinary tract infections when oral therapy cannot be given and when nitrofutantoin can be shown to be the drug of choice. Contraindicadons: Anuria, oliguria, or extensive impairment of renal function; infants under one month, pregnant patients at term; known hypersensitivity. Warnings: May cause hemolytic anemia of the primaquine sensitivity type, apparently linked to a glucose-6-phosphate dehydrogenase deficiency (found in 10% of Negroes and in a small percentage of ethnic groups of Mediterranean and Near-Eastern origin. Such patients should be closely observed while receiving nitrofurantoin). Discontinue the drug at any sign of hemolysis. Hemolysis ceases on withdrawal. Superinfections (limited to the genitourinary tract) may occur, most commonly due to Pseudomonas. Safety not established during pregnancy and lactation; should not be used in women of childbearing potential unless the expected benefits outweigh the possible hazards. Safety of FURADANTIN Sodium has not been established in children under 12. Precautions: Peripheral neuropathy may occur. A fatality has been reported. Predisposing conditions such as renal impairment, anemia, diabetes, electrolyte imbalance, vitamin B deficiency, and debilitating disease may enhance such occurrence. Adverse Reactions: Nausea, emesis and diarrhea may occur; reduction in dosage may alleviate these symptoms. Sensitization appearing as cutaneous eruptions or pruritus has occurred. Hypersensitivity reactions resulting in nonfatal anaphylaxis, angioedema, pulmonary infiltration with pleural effusion, and eosinophilia have been reported. Other passible reactions are chills, fever, jaundice, asthmatic symptoms and hypotension. Occasionally headache, dizziness, nystagmus, vertigo, drowsiness, malaise and muscular aches have occurred.Transient alopecia has been reported. Leukopenia, including granulocytopenia, has been reported rarely. The blood picture has returned to normal following cessation of therapy. Sunnlied: FURADANTIN (nitrofuranto&)* is supplied as round, yellow, bisected imprinted tablets of 50 mg (036) and 100 mg (037) in bottles of 25, 100, 500 and 1,000 tablets. Also available in hospital unit dose packages, strip-packaged in boxes of 100. FURADANTIN (nitrofurantoin) Oral Sus. pension, 25 mg per 5 cc. tsp., in bottles of 60 and 473 cc. FURADANTIN Sodium (nitrofurantoin sodium) is supplied in 20 cc. vials containing one sterile adult dose equivalent to 180 mg of FURADANTIN (nitrofurantoin) NOTE: Mix just prior to use. Do not use intravenously without further dilution. @ Originators and Developers of The Nirrofuranr EATON LABORATOR& division of Morton-Norwich Products, Inc. NORWICH, NEW YORK 13811
recurrent urinary tract infections, and hydronephrosis are most often seen. Excessive excretion of oxalic, glycolic, and glyoxylic acid occur in this disease. The treatment of oxalosis has proved to be most unsatisfactory. High fluid intake, the administration of phosphate in large doses to inhibit crystal formation, and the use of pyridoxine in doses of 150 mg. per day have been recommended. Hemodialysis has been generally unsuccessful, although it temporarily reduces the concentration of oxalate. Homotransplantation has also proved unsuccessful; at autopsy, kidneys have shown oxalate deposition. The authors recommend high fluid intake, early diagnosis, and the determination of urinary oxalate excretion in patients with calcium oxalate stones. Studies on Renal Function After Relief of Complete Unilateral Ureteral Obstruction of Three Months’ Duration in Man, Ori S. Better, A. I. Arieff, S. G. Massry, C. R. Kleeman, and M. H. Maxwell (54: 234, 1973)-A case is presented in which a ureter was ligated inadvertently following pelvic surgery for massive uterine hemorrhage and was not detected for three months. A nephrostomy was performed, and a controlled study with the opposite kidney serving as the control was established to monitor the degree of return of function. At the time of the nephrostomy, the creatinine clearance was 2.7 ml. per minute. This rose to 10.2 ml. per minute within one week but remained unchanged thereafter. The filtration fraction (Cw : CPAH) was 0.22 in the normal kidney and 0.19 in the diseased kidney. The normal kidney concentrated three times better than the involved side. Phosphate excretion and the ability to acidify the urine were both diminished on the involved side. There was increased excretion of sodium chloride; however, the free water clearance was supernormal. Ureteral obstruction occurs in approximately 2 per cent of pelvic surgery. The authors have shown that even after complete obstruction for three months, a kidney able to support life can be salvaged with appropriate reconstructive surgery.
JOURNALOFUROLOGY by Daniel
Howard,
M.D.
Ultrasonically Guided Renal Cyst Aspiration, Barry B. Goldberg, and Howard M. Pollack (109: 5, 1973)In this report the authors describe their technique of utilizing ultrasound to differentiate cystic from solid mass found pyelographically and to aid in placing a needle within the cyst for aspiration. A specifically modified ultrasonic transducer containing a central lumen permitted ultrasound to be used as a guide in renal cyst aspiration. Sixteen patients with proved renal cysts underwent cyst aspiration with the use of this technique. The ultrasonic transducer was first used to localize the cyst and to provide information as to the exact size and depth of the mass. Utilizing this knowledge the proper length needle was selected, and a needle was passed through the lumen in the transducer into the tissues.
340
UROLOGY
/ SEPTEMBER
1973
Furada&@ Tablet.9 (nitrofurantoin) Furadantin Oral Suspension (nitrofurantoin). Furadantin Sodium Parenteral (nitrofurantoinsodium). Indications: Indicatedfor the treatment of pyelonephritis, pyelitis and cystitis due to E. coli, enterococci, Staph. aureus, some strains of Klebsiella-Aerobacter and Proteus, or a small percentage of strains of Pseudomonas, when demonstrated to be susceptible by in vitro susceptibility testing. Not indicated for the treatment of renal cortical or perinephric abscesses, systemic infections, prostatitis, or in any genitourinary tract infections other than pyelonephritis, pyelitis or cystitis. FURADANTIN Sodium should be used only in patients with clinically significant urinary tract infections when oral therapy cannot be given and when nitrofutantoin can be shown to be the drug of choice. Contraindicadons: Anuria, oliguria, or extensive impairment of renal function; infants under one month, pregnant patients at term; known hypersensitivity. Warnings: May cause hemolytic anemia of the primaquine sensitivity type, apparently linked to a glucose-6-phosphate dehydrogenase deficiency (found in 10% of Negroes and in a small percentage of ethnic groups of Mediterranean and Near-Eastern origin. Such patients should be closely observed while receiving nitrofurantoin). Discontinue the drug at any sign of hemolysis. Hemolysis ceases on withdrawal. Superinfections (limited to the genitourinary tract) may occur, most commonly due to Pseudomonas. Safety not established during pregnancy and lactation; should not be used in women of childbearing potential unless the expected benefits outweigh the possible hazards. Safety of FURADANTIN Sodium has not been established in children under 12. Precautions: Peripheral neuropathy may occur. A fatality has been reported. Predisposing conditions such as renal impairment, anemia, diabetes, electrolyte imbalance, vitamin B deficiency, and debilitating disease may enhance such occurrence. Adverse Reactions: Nausea, emesis and diarrhea may occur; reduction in dosage may alleviate these symptoms. Sensitization appearing as cutaneous eruptions or pruritus has occurred. Hypersensitivity reactions resulting in nonfatal anaphylaxis, angioedema, pulmonary infiltration with pleural effusion, and eosinophilia have been reported. Other passible reactions are chills, fever, jaundice, asthmatic symptoms and hypotension. Occasionally headache, dizziness, nystagmus, vertigo, drowsiness, malaise and muscular aches have occurred.Transient alopecia has been reported. Leukopenia, including granulocytopenia, has been reported rarely. The blood picture has returned to normal following cessation of therapy. Sunnlied: FURADANTIN (nitrofuranto&)* is supplied as round, yellow, bisected imprinted tablets of 50 mg (036) and 100 mg (037) in bottles of 25, 100, 500 and 1,000 tablets. Also available in hospital unit dose packages, strip-packaged in boxes of 100. FURADANTIN (nitrofurantoin) Oral Sus. pension, 25 mg per 5 cc. tsp., in bottles of 60 and 473 cc. FURADANTIN Sodium (nitrofurantoin sodium) is supplied in 20 cc. vials containing one sterile adult dose equivalent to 180 mg of FURADANTIN (nitrofurantoin) NOTE: Mix just prior to use. Do not use intravenously without further dilution. @ Originators and Developers of The Nirrofuranr EATON LABORATOR& division of Morton-Norwich Products, Inc. NORWICH, NEW YORK 13811