[Experimental findings on oblique interrenal section of the inferior vena cava].
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Biomedical subjects
Publications and source records attributed to D Turini.
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Two patients with staghorn renal calculi underwent bench surgery and autotransplantation. A discussion is presented on the value of an extracorporeal procedure for patients with staghorn calculi associated with renal artery or pyeloureteral junction stenosis.
The association of pharmaco-angiography with norepinephrine and transcatheter arterial embolization is a technique used to obstruct arteries invaded by renal carcinoma. We treated 4 patients with this method before nephrectomy and recommend its use as a complement to an operation for renal carcinoma or as definitive treatment in poor surgical candidates.
2 cases of embolism in single functioning kidneys are reported. In the first case there was an occlusion of the main trunk of the renal artery; the patient was treated by embolectomy. In the second case the occlusion of a major arterial branch was demonstrated; because of the bad general conditions the patient was treated with medical therapy. The authors review the literature and the indications for embolectomy in embolism in a solitary kidney.
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Epinephrine (E), norepinephrine (NE), dopamine (DA) and cortisol (F) were measured in samples drawn simultaneously by direct venepuncture from the brachial and the adrenal vein of 12 patients undergoing surgery for left kidney diseases. In 7 patients the influence of anesthesia on peripheral plasma levels was also assessed. Catecholamines were measured by a radioenzymatic assay and F by radioimmunoassay. Compared to basal values (mean +/- SE) (E: 53.6 +/- 6.2 pg/ml; NE: 209.4 +/- 24.4 pg/ml; DA: 24.5 +/- 3.3 pg/ml; F: 12.9 +/- 1.2 micrograms/dl) only NE peripheral levels were significantly modified by anesthesia (NE: 343.7 +/- 67.4 pg/ml p less than 0.05), whereas under surgery a significant increase in the peripheral levels was found for every substance measured (mean +/- SE) (E: 332.5 +/- 46.6 pg/ml p less than 0.001; NE: 633.6 +/- 114.2 pg/ml p less than 0.005; DA: 85.8 +/- 15.7 pg/ml p less than 0.005; F: 21.3 +/- 1.9 micrograms/dl p less than 0.01). Catecholamine and F levels in adrenal vein showed a high variability suggesting an intermittent secretion. In the adrenal venous blood E levels were, in the mean, 381 times higher, NE levels 45 times, DA levels 27 times and F levels 23 times higher than in peripheral blood. E, NE and DA concentrations in the adrenal vein were all significantly correlated to the others but not to cortisol, suggesting that the medulla secrets E, NE and DA in rather constant ratios and that the cortex and the medulla respond differently to surgical stress.
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