Harold P. McDonald

Anuria Following Urography with Meglumine Diatrizoate (Renografin) in Multiple Myeloma

Only 11 cases of multiple myeloma with anuria attributable to urography have been documented. The agents used in the previous cases have been iodopyracet (Diodone and Diodrast), diodondiaethanolaminum (Nycotract), and sodium acetrizoate (Urokon Sodium) (1–10). This is the first reported case of anuria following the use of meglumine diatrizoate (Renografin) as the contrast medium. Case Report A normotensive 59-year-old Caucasian woman was admitted on March 8, 1967, with intermittent, severe lumbosacral pain of three weeks duration, urinary frequency, oral temperature of 101° F, and slight dehydration. Urinalysis revealed 1+ proteinuria, granular casts, and bacteriuria. Abdominal roentgenography demonstrated bilateral calcific densities opposite the lumbar vertebrae. Urography performed on March 9 with 50 cc of Renografin-60 (before the results of the renal function tests were obtained) showed nonvisualization of the collecting system. Laboratory determinations revealed a blood urea nitrogen of 130 mg per 1...

Angiographic Study of Arteriovenous Shunt in Hemodialysis Patients

ONE OF THE significant medical advances of the past decade is that a considerable number of patients with end-stage kidney disease can be maintained in reasonably good health by the use of chronic hemodialysis. The artificial kidn ey was first introduced by Abel, Rountree, and Turner in 1913 (1), yet technical problems associated with intermittent hemodialysis were not solved until 1960 when Quinton, Scribner, and their associates (2, 3) introduced the Teflon shunt. This technic of using a permanent indw elling Teflon cannula opened up the era of intermittent hemodialysis. The “Scribner” cannula consists of Teflon tubing inserted into both the artery and vein and joined via a Silast ic connector (4) which creates a permanently patent arteriovenous fistula (Fig. 1). The t echnic permits dialysis at any time after a single cannulation without anticoagulation and with decreased risk of infection. Aside from the economic limitations, the most difficult problem associated with dialysis has been the maintenance...

Neglected affections and lesions of the deep urethra

Abstract Attention is directed to the importance of more careful and well-timed studies of the prostatic urethra. The symptoms of disorders in this area are numerous but often are misleading; they are of value in leading to investigations which result in correct diagnoses. The diagnosis is not difficult if studies are made with a good urethroscope. If employed with reasonable skill and cystoscopic dexterity, the treatment of chronic affections and lesions of the deep urethra is generally quite satisfactory. The high frequency current, cutting and fulgurating, and topical applications are the agencies usually employed.

DISORDERS AND LESIONS OF THE MALE URETHRA: OFFICE PROCEDURES

Disorders of the male urethra are the cause of many disturbing symptoms. They are due chiefly to inflammatory conditions, obstructions and hyperemia or hyperesthesia. These disorders manifest themselves chiefly as abnormal discharges, urinary irritation and sexual disturbances. Inflammation and obstructions are intimately related. By this is meant localized inflammatory processes tending to produce fibrosis and obstructions in the areas so affected. It is equally true that obstructed areas in the urethra, whether congenital or acquired, tend to harbor infection. Each tends to perpetuate the other; inflammation produces fibrosis and obstructions, which in turn hinder the cure of infected areas. Considerable judgment is required at times, especially in chronic recurrent inflammation, to determine the correct plan of treatment. Formerly it was deemed inadvisable to dilate inflamed areas in the urethra even though an obstruction was known to be present and keeping up the inflammation; since the advent of sulfonamide compounds, however,

Phymosis and paraphymosis; circumcision; dorsal slit; constriction of male meatus

Abstract While these affections usually are of minor importance, at times they may produce very serious complications. Individuals in need of circumcision undoubtedly are more likely to contract syphilis and chancroidal infection than are the circumcised. Cancer of the penis is practically never seen except in men who are in need of circumcision and especially is it likely to arise when the foreskin is adherent to the glans penis. Phymosis which develops secondarily to chancroidal infection may result in extensive destruction of the penis because of the difficulty in applying treatment. The average doctor does not regard a small meatus as a matter of much concern. Yet it is often the unsuspected cause of non-specific urethritis, irritation of the deep urethra, disorders of the sexual function, prolonged gonorrheal infection, and other complaints. Meatotomy with sutures to control hemorrhage and hasten healing gives better results than meatotomy as ordinarily done.