Roderick D. Turner

Ferromagnetic Silicone Necrosis of Hypernephromas by Selective Vascular Occlusion to the Tumor: A New Technique

Arterial vascular occlusion of hypernephromas may be performed by obstructiing the tumor vascular tree with the injection of ferromagnetic silicone microspheres. The powerful superconducting electromagnet confines the embolized iron-silicone compound to the neoplastic target organ. Radioactive material may or may not be added to the iron-silicone compound to give local direct radioactive radiation therapy to the tumor area. In experimental dogs up to 70,000 rad of beta radiation from the P32 source had been delivered homogeneously within the kidney when mixed with the ferrosilicone. This technique may well be used in cases in which a major operation is contraindicated or when preoperative necrosis of the tumor is advisable. Since the entire procedure can be done with the patient under local anesthesia in a radiology department it may be a valuable new technique in the future management of urological tumors, unilateral renal hypertension, solitary kidney pathology and so forth. Ferrosilicone material has not been found to be toxic. The application of a powerful superconducting electromagnet to the technique provides a means of confining the embolized iron-silicone compound to the target organ.

The surgeon, the urologist and the patient with abdominal pain

Abstract All of these retroperitoneal causes of abdominal pain must be considered in the differential diagnosis of an acute condition of the abdomen. Important points in the study of the urinary tract before surgical exploration for unexplained abdominal pain are the following: (1) Accurate history and physical examination. (2) Careful microscopic examination of freshly voided urine in three separate glasses. (3) A “scout” roentgenogram of the abdomen to discover calculi or foreign bodies. (4) An intravenous urogram. (This is perhaps the most valuable of any single test in ruling the urinary tract in or out as a cause of unexplained abdominal pain. It should always be employed when the diagnosis is in doubt. Judging from the number of errors collected in this series, this simple and brief test should have been used in many more cases than is now the custom). (5) Cystoscopy, retrograde pyelography and, if necessary, retroperitoneal gas study and aortography may aid in the diagnosis of retroperitoneal disease. These procedures should be freely employed as diagnostic measures whenever indicated. Retroperitoneal structures should always be included in consideration of the surgical causes of acute abdominal pain. The careful surgeon will insist on an intravenous urogram before abdominal exploration when the diagnosis is not absolutely certain. The knowledge gained concerning the condition of the urinary tract and the opposite kidney in cases of unilateral renal disease may prove lifesaving at the time of surgical exploration.