Adult or infantile polycystic disease?
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Biomedical subjects
Publications and source records attributed to H M Pollack.
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A review of some of the more important limitations and pitfalls in the interpretation of excretory urograms is presented. Although there is no infallible method of avoiding interpretive errors it is suggested that the development of good viewing habits, including an orderly and systematic appraisal of each film, coupled with a physiologically oriented approach to film interpretation will reduce mistakes significantly. Similarly, many pitfalls may be circumvented by the simple expedient of close collaboration between urologist and radiologist, and by the reluctance of either to accept urography that is suboptimal by current standards.
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Direct visualization of the interior of renal cysts by means of an endoscope inserted through an ultrasonically guided needle in the flank has been performed satisfactorily in 12 patients. Useful information was obtained in all cases. While the procedure is still experimental, it appears promising and worthy of further evaluation.
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B-scan ultrasound was used in 30 patients to localize the kidney prior to renal biopsy. The lower pole of the kidney was outlined in the longitudinal and transverase planes and the depth of the kidney was easily obtained from the ultrasonic tracings. The puncture site was marked on the skin and the angle of the needle pathway determined. Renal biopsy was performed successfully in 28 patients, which compares favorably with the results of other localization methods.
Four cases of herniation of the ureter are presented. A discussion of the various types of ureteral hernia is based on the roentgenographic features of each type as well as the anatomical considerations responsible for these radiographic signs. The use of erect and oblique projections in patients with hernias undergoing urography is urged. The sign of the curlicue ureter is felt to be pathognomonic for ureteral hernia.
Ultrasound was used to evaluate 100 pediatric patients suspected of having a mass. This technique was found to be useful in several ways: (1) differentiation of cystic, solid, and complex masses, which is not usually possible with routine roentgenographic evaluation; (2) delineation of free fluid collections from those that are loculated or contained within masses; (3) measurement of the size of both normal and abnormal structures; and (4) confirmation of the abnormal position or absence of organs. Ultrasound was used as a supplement to routine clinical and radiologic studies.
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