Marvin J. Friedenberg

Roentgen Size of Normal Kidneys

Size of the kidneys is an important consideration in the diagnosis, prognosis, course, and treatment of renal disease. One of the simplest and most direct methods of estimating renal size is from measurements made on an anteroposterior roentgenogram of the abdomen. Practical application of this information requires knowledge of the range in size of normal kidneys as determined by the same method. The purpose of this paper is to report the kidney size in 1,286 patients from a general hospital population without recognizable renal disease. The kidney size was measured on abdominal roentgenograms obtained during intravenous urography, expressed as a function of the patients body surface area, and correlated with the age, sex, and race. From these data, idealized normal (gaussian) distribution curves were constructed which indicate the range in size of normal kidneys in the population studied and the difference in size between each kidney in an individual subject. MaterialIncluded in this study were 1,286 in...

The Routine Use of Higher Volumes of Contrast Material to Improve Intravenous Urography

Abdominal roentgenography after the intravascular injection of a large volume of highly concentrated contrast material for cardiac and peripheral angiography usually demonstrates excellent opacification of the urinary tract. The dosage injected in these studies generally is determined by the patients weight. This method of dosage calculation has obvious merit for cardiovascular examinations and may be equally desirable for intravenous urography. To evaluate this thesis, a study was undertaken to determine the worth and hazard of the routine use of higher volumes of contrast material for intravenous urography, based upon the patients body-surface area. Material and Methods A total of 867 intravenous urographic examinations were performed in 787 patients, 304 men and 483 women. Table I indicates their ages according to decade. Six hundred were hospitalized, and 187 were out-patients. The contrast material, either 50 per cent sodium diatrizoate2 or 60 per cent methyl glucamine diatrizoate,3 was injected ma...

Primary Pulmonary Pseudolymphoma

Primary pulmonary pseudolymphoma is a benign lesion of the lung parenchyma, characterized histologically by the presence of true lymphoid germinal centers in a massive infiltrate of well differentiated lymphocytes and other inflammatory cells. For purposes of therapy and prognosis it is important to distinguish this lesion from primary pulmonary malignant lymphoma. This report correlates the clinical and pathological observations with the radiological findings in 10 cases of primary pulmonary pseudolymphoma seen during the years 1948 to 1962, 6 from the Barnes Hospital Group, and 4 in consultation. The authors previously reported 9 of the 10 cases in a review of lymphomatous tumors of the lung, but the radiological findings were not described (7). Clinical Findings The 10 patients ranged in age from thirty-eight to eighty, with an average of 56.3 years. There were 5 men and 5 women, all Caucasian. In 7 the lesions were detected in routine radiographic examinations of the chest, and the patients were compl...

Superior Mesenteric Arteriography in Experimental Mesenteric Venous Thrombosis

THE CLINICAL and roentgenographic diagnosis of acute mesenteric vascular occlusion is difficult (2) and frequently delayed, with a resultant high mortality (1). A reliable method is required for the early detection and differentiation of mesenteric venous and arterial obstruction. The purpose of this paper is to report the angiographic findings in dogs subjected to superior mesenteric arteriography after experimental induction of thrombosis of the superior mesenteric vein. Material and Methods Seven mongrel dogs, each weighing 14 to 24 kg, were fasted for twelve hours and then anesthetized with 25 mg of intravenous sodium pentobarbital per kilogram of body weight. An endotracheal tube was inserted, and the animals were ventilated with a Harvard piston respirator (Model 607A). A celiotomy was performed, and in the first 3 dogs a small polyethylene catheter was introduced into the superior mesenteric artery from an arteriotomy in the adjacent aorta. In subsequent dogs the preferable technic was to pass a cu...

Ilio-iliac arteriovenous fistula following intervertebral disc surgery

Summary The clinical and roentgenographic findings of an ilio-iliac arteriovenous fistula nine years following intravertebral disc surgery are described. The mode of injury is discussed, and the vascular injuries following disc surgery are reviewed.

Serotonin-induced pulmonary venous spasm demonstrated by selective pulmonary phlebography☆

Abstract Selective pulmonary phlebography before and after infusion of serotonin has graphically demonstrated active in vivo pulmonary venomotion for the first time. The evidence of venous constriction was of two types: (1) decreased retrograde pulmonary venous, capillary, and arterial filling, and (2) distinct changes in the caliber of the veins, with kinking and narrowing. These findings add further weight to the accumulating evidence of other types which indicates that the pulmonary veins are not merely passive channels, but serve an important hemodynamic function.

Association of subcapsular hematomas with the nonfunctioning kidney.

When an enlarged nonvisualizing kidney seen on excretory urography is associated with a relatively normal retrograde pyelogram and renal angiogram, the most likely diagnosis is a subcapsular hematoma. Differential diagnosis is important because patients may be expected to respond favorably to conservative management with return to normal in appearance and function of the kidney. Three cases are presented.

Artificially produced pulmonary artery stenosis in the dog

The genesis of the obstructive infundibular hypertrophy which is seen in association with pulmonary valvar stenosis, especially beyond infancy, has been explained upon an acquired basis (compensatory) but this has not been substantiated. Also, there are conflicting opinions about the necessity for resecting the infundibular muscle when the pulmonary valve is lysed. Experiments were devised using puppies in which the main pulmonary artery was banded. There was progressive increase in the right ventricular pressure, marked infundibular hypertrophy developed, as demonstrated by angiocardiography, and the cardiac output decreased. After 14 to 22 months, the pulmonary stenosis was relieved surgically and the infundibular region was not resected. After 2 to 10 months there was still significant infundibular hypertrophy. The right ventricular pressure returned to normal levels and the cardiac output increased. These experiments suggest that infundibular hypertrophy is an acquired complication of main pulmonary artery stenosis in the dog. In the human, valvotomy in infancy may prevent the development of infundibular hypertrophy. Valvotomy alone may be all that is needed, when there is an immediate drop in the right ventricular pressure, below 100 mm. Hg, at time of operation.

SELECTIVE PULMONARY PHLEBOGRAPHY; EXPERIMENTAL INVESTIGATION IN DOGS.

Angiographic examination of the pulmonary arteries is an established diagnostic technic (6, 8, 15). It may be accomplished by the injection of contrast material into one or more systemic veins, the right atrium, the right ventricle, or any portion of the pulmonary arterial system. If detailed examination of a localized portion of the pulmonary arterial tree is desired, selective pulmonary arteriography may be performed by advancing a catheter into a pulmonary artery branch (4, 5, 10). Satisfactory visualization of the pulmonary veins is more difficult. Pulmonary venous angiography (phlebography) usually has been achieved indirectly during the passage of contrast material through the pulmonary veins after injection into a systemic vein, a right heart chamber, or a pulmonary artery (11, 16). At best this method fails to provide sufficiently intense opacification of these veins for their detailed examination. To enhance the precise evaluation of pulmonary veins, the following experimental technic for selecti...

Improvement of Chest Roentgenography by Respirator-Controlled Pulmonary Inflation

Commonly available respirators may be used safely to improve the quality of chest radiographs in selected patients. The film is exposed following inflation of the lungs and during prevention of exhalation. This method is most effective in uncooperative, semiconscious, weak, or paralyzed patients.