Anthony F. Lalli

Aspiration Biopsies of Chest Lesions

1223 patients underwent aspiration biopsy with a diagnostic yield of 86.4%; 24.2% of the patients had a small pneumothorax, but only 4.4% required treatment; one patient developed a moderate hemothorax. The method, problems, and complications including morbidity and mortality are discussed. The relative success of aspiration biopsy with different lesions of the lung and mediastinum is identified.

Urographic contrast media reactions and anxiety.

Four groups of patients were tested for reactions to intravenous sodium iothala-mate for urography. Intravenous diazepam, subcutaneous atropine, and oral tincture of belladonna failed to reduce reactions to the contrast medium. Hypnotic suggestion was effective in reducing reactions to a statistically significant degree in nausea and vomiting and may also be helpful in urticaria. Anxiety appears to be the most important factor in so-called idiosyncratic reactions to urographie contrast media. Radiologists should perform these examinations in such a manner as to reduce this anxiety rather than increase it.

Retroperitoneal Fibrosis and Inapparent ObstructiveUropathy1

Emphasis is placed on the minor degree of caliectasis often observed in the presence of severe renal failure in patients with retroperitoneal fibrosis. This finding should suggest the diagnosis in individuals presenting with obscure causes of renal failure. A possible explanation for this is based upon an interference with ureteral dynamics and subsequent interference with normal ureteral peristatic activity rather than mechanical obstruction of the ureter per se. Twenty-one patients with retroperitoneal fibrosis are reported with the usual sex and age distribution (mostly male, aged 40-55 years). Two of the patients are interesting because of associated cardiac disease and 31 had been on prolonged methysergide therapy for migraine headaches. Eighteen patients appeared to be improved or cured and 3 died.

A new technique for urethrography.

The male urethra can be demonstrated following intravenous urography by having the patient void against the partial obstruction produced by a penile clamp. The clamp is useful for both the normal or stenosed male urethra.

The Infrequent Voider

We have been impressed with the fact that voiding with less than usual frequency can result in the development of urinary tract infections, renal failure, and the attendant difficulties. This is a little appreciated concept which can be suggested as a diagnostic possibility by the radiologist who performs and interprets excretory urograms and voiding cystourethrograms. The purpose of this communication is to report our experience and recommend methods whereby this important clinical problem may be recognized. The disease is not directly related to organic pathology but is capable of producing it by the late effects of abnormal habits of behavior. Material Twenty-one patients with this problem are reported here, although one of us (J. L.) has reported a larger experience elsewhere (11, 12). The data are summarized in Table I. One will note that females were involved twice as often as males, and although the age range was broad, peaks of incidence occurred at about ages five and twenty-one years. We have fe...

Diagnostic Percutaneous Opacification of Benign Pulmonary Lesions

The authors present 4 representative cases of benign pulmonary lesions accurately diagnosed by percutaneous aspiration and opacification. These conditions and others were encountered during needle biopsy for suspected malignant disease. The examiner must be prepared to inject contrast material when a fluid aspirate is obtained and should proceed with necessary studies even when a vascular lesion is encountered.

Radiology a Medical School Requirement

Radiologists should be alerted to the fact that radiology is not at the present time a required subject for graduation from many medical schools and that many academic radiologists acquiesce in such a state of affairs. The author presents cogent reasons why this should not be the case.